title: Carotid atherosclerosis is not associated with lower bone mineral density and vertebral fractures in patients with systemic lupus erythematosus.
abstract: BACKGROUND
  Low bone mineral density (BMD) and vertebral fractures (VF) have been associated with atherosclerosis in the general population. We sought to investigate the relationship between BMD and VF and carotid atherosclerosis in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  We studied 122 women with SLE. All patients had BMD, carotid intima-media thickness (IMT), and carotid artery atherosclerotic plaque assessment by ultrasound.
  
  
  RESULTS
  Mean age at study entry was 44 years and mean disease duration was 11 years. Carotid plaque was found in 13 (11%) patients (9 postmenopausal and 4 premenopausal). Patients in the highest IMT quartile were more likely to be older (p = 0.001), have a higher body mass index (p = 0.008), and exhibit dyslipidemia at study entry (p = 0.041), compared with the lower three quartiles. BMD at the lumbar spine was lower in patients in the highest IMT quartile compared with the lower quartiles in the multivariate logistic analysis, however, there was no association between lumbar or total hip BMD and IMT (p = 0.91 and p = 0.6, respectively). IMT measurements did not differ according to the presence or absence of VF (0.08 ± 0.12 vs. 0.06 ± 0.03 mm, p = 0.11). A trend towards higher incidence of VF was found in patients with carotid plaque compared with those without (33% vs. 21%; p = 0.2).
  
  
  CONCLUSIONS
  In patients with SLE, the presence of carotid atherosclerosis is not associated with low BMD or VF.
authors.affiliation: Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Mexico.
authors.forename: C
authors.initials: C
authors.lastname: Mendoza-Pinto
authors.affiliation: Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: García-Carrasco
authors.affiliation: Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez-Hernández
authors.affiliation: Cardiovascular Unit, Fundación de Cuore, Puebla, Mexico.
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-Pérez
authors.affiliation: Division of Interventional Cardiology, Medstar Hospital Center, Washington, USA.
authors.forename: R O
authors.initials: RO
authors.lastname: Escárcega
authors.affiliation: Clinical Epidemiology Research Unit, IMSS, Guadalajara, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Nava-Zavala
authors.affiliation: Systemic Autoimmune Diseases Research Unit, IMSS, Puebla, Mexico.
authors.forename: P
authors.initials: P
authors.lastname: Munguía-Realpozo
authors.affiliation: State Research Department, Research Unit, IMSS, Puebla, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: López-Colombo
authors.affiliation: Clinical Research Department, UMAE, Centro Médico Nacional IMSS, Mexico.
authors.forename: L J
authors.initials: LJ
authors.lastname: Jara
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain rcervera@clinic.cat.
authors.forename: R
authors.initials: R
authors.lastname: Cervera
mesh_terms: D000077:Acetabulum / Q000503:physiopathology; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005270:Femur Head / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000503:physiopathology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D017698:Postmenopause; D017697:Premenopause; D011859:Radiography; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013904:Thoracic Vertebrae / Q000293:injuries*
keywords: Bone mineral density; subclinical atherosclerosis; systemic lupus erythematosus; vertebral fractures