title: Bone density is normal and does not change over 2 years in sarcoidosis.
abstract: CONCLUSIONS
  Small studies have previously suggested that sarcoidosis may be associated with low bone mineral density. In this observational study of 64 patients with sarcoidosis, bone mineral density was within the normal range at baseline, and there was no evidence of accelerated bone loss over 1-2 years.
  
  
  BACKGROUND
  Several small studies have suggested that sarcoidosis may be associated with low bone mineral density (BMD).
  
  
  METHODS
  We undertook a cross-sectional study of BMD in 64 patients with sarcoidosis. Of these, 27 with 25-hydroxyvitamin D<50 nmol/L entered a 1-year intervention study of vitamin D supplements, and 37 entered a 2-year longitudinal study of BMD, with the primary endpoint of the change in lumbar spine BMD.
  
  
  RESULTS
  The mean age of participants was 58 years, 68% were female, and 8% were currently using oral glucocorticoids. At baseline, BMD for the entire cohort was greater than the expected values for the population at the lumbar spine (mean Z-score 0.7, P<0.001) and total body (0.5, P<0.001) and similar to expected values at the femoral neck (0.2, P=0.14) and total hip (0.2, P=0.14). BMD did not change at any of these four sites (P>0.19) over 2 years in the longitudinal study. In the intervention study, vitamin D supplements had no effect on BMD, and therefore we pooled the data from all participants. BMD did not change over 1 year at the spine, total hip, or femoral neck (P>0.3), but decreased by 0.7% (95% confidence interval 0.3-1.1) at the total body (P=0.019).
  
  
  CONCLUSIONS
  BMD was normal at baseline, and there was no consistent evidence of accelerated bone loss over 1-2 years, regardless of baseline vitamin D status. Patients with sarcoidosis not using oral glucocorticoids do not need routine monitoring of BMD.
authors.affiliation: Department of Medicine, University of Auckland, Private Bag 92 019, Auckland, 1142, New Zealand, m.bolland@auckland.ac.nz.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bolland
authors.forename: M L
authors.initials: ML
authors.lastname: Wilsher
authors.forename: A
authors.initials: A
authors.lastname: Grey
authors.forename: A M
authors.initials: AM
authors.lastname: Horne
authors.forename: S
authors.initials: S
authors.lastname: Fenwick
authors.forename: G D
authors.initials: GD
authors.lastname: Gamble
authors.forename: I R
authors.initials: IR
authors.lastname: Reid
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000097:blood / Q000503:physiopathology*; D017565:Sarcoidosis, Pulmonary / Q000097:blood / Q000503:physiopathology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D