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Osteoporosis screening in systemic lupus erythematosus: impact of disease duration and organ damage

Department of Rheumatology, Heinrich-Heine-UniversitätDüsseldorf, Moorenstr 5, D-40225, Düsseldorf, Germany.becker{at}rheumanet.org

R Fischer

Department of Rheumatology, Heinrich-Heine-UniversitätDüsseldorf, Düsseldorf, Germany

W A Scherbaum

Department of Endocrinology, Heinrich-Heine-UniversitätDüsseldorf, Düsseldorf, Germany

M Schneider

Department of Rheumatology, Heinrich-Heine-UniversitätDüsseldorf, Düsseldorf, Germany

The aim of the present studywas to assess the effects of disease severityand demonstrable organ damage as risk factors for the development of osteoporosis in systemic lupus erythematosus (SLE). Sixty-four SLE patients were included. Mean disease duration was 7.7–5.7 y. Thirty-two patients had persistent organ damage, defined as SLICC-ACR damage score 1. Disease activitymeasured bySLAM-2 ranged from 3 to 27. Bone mineral density(BMD) measurements were performed with dual X-rayabsorptiometry. In addition, biochemical markers of bone metabolism were studied.

BMD was inverselycorrelated with disease duration, damage score and cumulative glucocorticoid intake, but no correlation was found for current glucocortioid use or with markers of bone metabolism. In a multivariate analysis, body weight, disease duration and damage index fitted best for the prediction of BMD at both lumbar spine and femoral neck. Seven out of 64 patients had osteoporosis according to WHO criteria.

In conclusion, severe osteoporosis is uncommon in lupus patients. Disease activityand severity were no major risk factors for loss of BMD in this study, but persistent non-bone-related organ damage was significantlylinked to the presence of osteoporosis measured as decreased BMD. Our data suggest that, in addition to patients receiving glucocorticoids, patients with an SLICC-ACR 1 or a disease duration 7 ymight benefit from regular monitoring of BMD as secondary prevention of damage.

Key Words: SLICC-ACR • bone density • bone metabolism

Lupus, Vol. 10, No. 11, 809-814 (2001)
DOI: 10.1177/096120330101001108


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