title: Bone mineral density change in systemic lupus erythematosus: a 5-year followup study.
abstract: OBJECTIVE
  To determine changes of bone mineral density (BMD) over a 5-year period in a cohort of female patients with systemic lupus erythematosus (SLE) and to identify factors predictive of BMD loss.
  
  
  METHODS
  Our longitudinal study involved 125 female patients with SLE with a mean (SD) age of 46.5 years (10.1) and a median disease duration of 10.4 years. Demographics and clinical data were collected and BMD at the femoral neck, total hip, and lumbar spine (L1-4) was performed by using dual-energy x-ray absorptiometry at baseline and followup.
  
  
  RESULTS
  Average percentage changes of BMD over a mean followup of 5 years were -2.41% at the femoral neck, -1.63% at the total hip, and -0.62% at the lumbar spine, with significant changes at both the femoral neck (p < 0.0001) and total hip (p < 0.0005), but not at the lumbar spine (p = 0.128). Disease flare, new organ damage, and use of glucocorticoids during followup were significantly associated with larger decreases in BMD. BMD loss was arrested at the femoral neck and BMD increased at the total hip and lumbar spine in patients receiving antiosteoporosis therapy. In multivariate analyses, use of antiosteoporosis therapy was independently associated with increased BMD at any site and new organ damage was an independent predictor of BMD loss at the femoral neck.
  
  
  CONCLUSIONS
  Significant BMD loss at the hip over a period of 5 years was found in patients with SLE. Disease activity, disease damage, and use of glucocorticoids are the disease-specific variables that contribute to bone loss in SLE.
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: James F
authors.initials: JF
authors.lastname: Griffith
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Sze-Ki
authors.initials: SK
authors.lastname: Au
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Tang
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Kwok
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Ping-Chung
authors.initials: PC
authors.lastname: Leung
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.affiliation: From the Department of Medicine and Therapeutics; Department of Imaging and Interventional Radiology; and The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.T.Y. Zhu, PhD, Department of Medicine and Therapeutics; J.F. Griffith, MD, Department of Imaging and Interventional Radiology; S-K. Au, MPhil, The Jockey Club Centre for Osteoporosis Care and Control; X-L. Tang, PhD, Department of Medicine and Therapeutics; A.W. Kwok, MPhil; P-C. Leung, DSc, The Jockey Club Centre for Osteoporosis Care and Control; E.K. Li, FRCP; L-S. Tam, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong. lstam@cuhk.edu.hk.
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011237:Predictive Value of Tests
keywords: BONE MINERAL DENSITY; GLUCOCORTICOIDS; ORGAN DAMAGE; SYSTEMIC LUPUS ERYTHEMATOSUS