Journal
JOURNAL OF RHEUMATOLOGY
Volume 39, Issue 7, Pages 1378-1384Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.111589
Keywords
SYSTEMIC LUPUS ERYTHEMATOSUS; OSTEOPOROSIS
Categories
Funding
- Canadian Institutes of Health Research [MCT82939]
- Canadian Rheumatology Association-Roche Research Studentship
- Canadian Institutes of Health Research Senior Investigator Award
- Arthritis Centre of Excellence, University of Toronto
- centre de recherche du centre hospitalier universitaire de Quebec
- Smythe Foundation
- Lupus Ontario
- Dance for the Cure
- Flare for Fashion
- Lupus Foundation of Ontario
- Singer Family Fund for Lupus Research
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Objective. Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure. Methods. Women without prior OP fractures were eligible. Bone mineral densities at the hip, spine, and femoral neck were determined using dual-energy x-ray absorptiometry. OP was determined using World Health Organization definitions for participants aged >= 50 years (32.8%), and LBM was defined as Z-scores <= -2.0 for those aged <50 years. For those aged >= 40 years (63.5%), the 10-year probabilities of a major fracture (FRAX-Major) and hip fracture (FRAX-Hip) were calculated. FRAX-Major >= 20% or Hip >= 3% was considered high risk. HSA was done in a subgroup (n = 81) of patients. Results. The study group was 271 women. Mean (SD) age was 43.8 (13.1) years and SLE duration was 11.6 (10.4) years. OP was diagnosed in 14.6% and LBM in 8.8%. FRAX-Major >= 20% was seen in 9 patients (5.3%), of whom 6 were taking OP medications. FRAX-Hip >= 3% occurred in 16 patients (9.4%), of whom 9 were taking OP medications. Buckling ratio at the left hip narrow neck was positively correlated with FRAX-Major, FRAX-Hip, SLE duration, and duration of corticosteroid use. Conclusion. LBM is prevalent in women with SLE who are < 50 years of age. FRAX may identify those at higher risk of fractures while HSA can assess bone structure noninvasively. (First Release June 12012; J Rheumatol 2012;39:1378-84; doi:10.3899/jrheum.111589)
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