title: Bone microarchitecture assessment by high-resolution peripheral quantitative computed tomography in patients with systemic lupus erythematosus taking corticosteroids.
abstract: OBJECTIVE
  We assessed the relationship between vertebral fracture and bone microarchitecture in patients with systemic lupus erythematosus (SLE) on chronic corticosteroid therapy using high-resolution peripheral quantitative computed tomography (HR-pQCT).
  
  
  METHODS
  Fifty-nine Chinese women with SLE taking corticosteroid were selected to participate in a cross-sectional study. Vertebral fracture was confirmed semiquantitatively by lateral radiographs of the thoracic and lumbar spine. Density and microarchitecture at the distal radius were measured with HR-pQCT. Areal bone mineral density (aBMD) at hip and lumbar spine was measured by dual-energy X-ray absorptiometry (DEXA).
  
  
  RESULTS
  Twelve patients had vertebral fractures. The aBMD of spine or hip did not differ between those with and without vertebral fractures. Measures by HR-pQCT revealed that patients with vertebral fractures had significantly lower level of average bone density (p = 0.007), cortical bone density (p = 0.029), trabecular bone density (p = 0.024), trabecular bone volume to tissue volume (p = 0.023), and trabecular thickness (p = 0.011) than those without vertebral fractures. Independent explanatory variables associated with higher risk of vertebral fractures were older age (p = 0.013) and lower average cortical bone density (p = 0.029).
  
  
  CONCLUSIONS
  Vertebral fracture in patients with SLE on chronic corticosteroid treatment was associated with alterations of bone density and microarchitectures measured by HR-pQCT and DEXA. However, alterations were more pronounced in measurements by HR-pQCT. Low cortical bone density and old age were significant predictors of vertebral fracture risk.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong. edmundli@cuhk.edu.hk
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Hung
authors.forename: James F
authors.initials: JF
authors.lastname: Griffith
authors.forename: Tena K
authors.initials: TK
authors.lastname: Li
authors.forename: Martin
authors.initials: M
authors.lastname: Li
authors.forename: Kong Chiu
authors.initials: KC
authors.lastname: Wong
authors.forename: Ping Chung
authors.initials: PC
authors.lastname: Leung
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Kwok
authors.forename: Ling
authors.initials: L
authors.lastname: Qin
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D000328:Adult; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects / Q000648:ultrastructure; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones