title: Influence of prevalent vertebral fractures on the quality of life of patients with systemic lupus erythematosus.
abstract: BACKGROUND
  The prevalence of vertebral fractures in systemic lupus erythematosus (SLE) ranges between 20% and 21.4%, and patients with these fractures have impaired walking and activities of daily living. Moreover, clinical and radiological vertebral fractures have been associated with increased mortality.
  
  
  OBJECTIVE
  To compare the quality of life of patients with SLE with and without vertebral fractures.
  
  
  METHODS
  The study group comprised 140 women with SLE undergoing screening for vertebral fractures using a standardized method. SLE disease activity and organ damage were measured by the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) and the Systemic International Collaborating Clinics/American College of Rheumatology damage index (SLICC), respectively. The QUALEFFO and Center for Epidemiologic Studies Depression Scale were used to measure health-related quality of life and depression, respectively.
  
  
  RESULTS
  The median age of the 140 patients was 43 years (range 18-76); disease duration was 72 months (range 6-432); 49.7% were menopausal. Thirty-four patients (24.8%) had vertebral fractures (> or = 1), mostly in the thoracic spine. Patients with vertebral fractures had a higher mean age (49.5 +/- 13.4 vs. 41 - 13.2 years, P= 0.001) and disease damage (57.1% vs. 34.4%, P = 0.001). The global QUALEFFO score was not different between the vertebral fractures group and the non-vertebral group. The only significant difference in the QUALEFFO items was in physical function (P = 0.04). A significant correlation was found between the severity of vertebral fractures and the QUALEFFO pain (r = 0.27, P = 0.001) and physical function (r = 0.37, P = 0.02) scores. The number of vertebral fractures correlated only with physical function (r = 0.01).
  
  
  CONCLUSIONS
  The HRQOL of women with SLE is low, regardless of whether they have vertebral fractures or not, but patients with vertebral fractures have worse physical function compared to those without. Strategies to improve the HRQOL of patients with SLE with or without vertebral fractures are necessary.
authors.affiliation: Systemic Autoimmune Diseases Research Unit, HGR #36, Instituto Mexicano del Seguro Social, Puebla, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Garciá-Carrasco
authors.forename: Claudia
authors.initials: C
authors.lastname: Mendoza-Pinto
authors.forename: Carlos
authors.initials: C
authors.lastname: Riebeling
authors.forename: Manuel
authors.initials: M
authors.lastname: Sandoval-Cruz
authors.forename: Arnulfo
authors.initials: A
authors.lastname: Nava
authors.forename: Ivet
authors.initials: I
authors.lastname: Etchegaray-Morales
authors.forename: Mario
authors.initials: M
authors.lastname: Jiménez-Hernández
authors.forename: Alvaro
authors.initials: A
authors.lastname: Montiel-Jarquín
authors.forename: Aurelio
authors.initials: A
authors.lastname: López-Colombo
authors.forename: Ricard
authors.initials: R
authors.lastname: Cervera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000523:psychology*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015996:Survival Rate / Q000639:trends; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D055815:Young Adult