Uaratanawong Somchai, Deesomchoke Utis, Lertmaharit Somrat, Uaratanawong Somsri
Rheumatology Unit, Department of Medicine, Bangkok Metropolitan Medical College and Vajira Hospital, 681 Samsen Road, Dusit, Bangkok 10300, Thailand.
J Rheumatol. 2003 Nov;30(11):2365-8.
To study bone mineral density (BMD) in premenopausal women with systemic lupus erythematosus (SLE) and to evaluate the influence of disease activity and use of corticosteroids.
A cross-sectional study on BMD of 118 premenopausal women with SLE. Patients were divided into 2 groups, 74 who had been treated with corticosteroids and 44 who had not. BMD at lumbar spine, femoral neck, and trochanter was measured.
BMD in patients without and with corticosteroid treatment was 1.13 +/- 0.13 vs 1.05 +/- 0.14 g/cm2 (p = 0.005) at lumbar spine, 0.92 +/- 0.12 vs 0.86 +/- 0.12 g/cm2 (p = 0.005) at femoral neck, and 0.78 +/- 0.13 vs 0.72 +/- 0.12 g/cm2 (p = 0.014) at trochanter, respectively. Stepwise multilinear regression analysis showed that corticosteroid exposure was independently associated with decreased BMD in the corticosteroid treated patients (r2 = 7% for lumbar and 6.6% for trochanter model). No significant difference in BMD in corticosteroid treated patients appeared when they were subgrouped according to whether they were taking calcium supplements. Prevalence of osteoporosis at lumbar spine in corticosteroid treated patients was 1.4%, and was lower than reported for age and sex matched Caucasians.
BMD measurements were significantly lower in premenopausal SLE patients who had had corticosteroid treatment than those who had not. There was a negative correlation between BMD and corticosteroid therapy, but not disease activity. Prevalence of osteoporosis, based on lumbar spine BMD, was lower than that reported in Caucasians.
研究绝经前系统性红斑狼疮（SLE）女性的骨密度（BMD），并评估疾病活动度和使用皮质类固醇的影响。
对118例绝经前SLE女性的骨密度进行横断面研究。患者分为两组，74例接受过皮质类固醇治疗，44例未接受过治疗。测量腰椎、股骨颈和大转子处的骨密度。
未接受皮质类固醇治疗和接受过治疗的患者，腰椎骨密度分别为1.13±0.13 vs 1.05±0.14 g/cm²（p = 0.005），股骨颈骨密度为0.92±0.12 vs 0.86±0.12 g/cm²（p = 0.005），大转子处骨密度为0.78±0.13 vs 0.72±0.12 g/cm²（p = 0.014）。逐步多元线性回归分析显示，在接受皮质类固醇治疗的患者中，皮质类固醇暴露与骨密度降低独立相关（腰椎模型r² = 7%，大转子模型r² = 6.6%）。接受皮质类固醇治疗的患者根据是否服用钙剂进行亚组分析时，骨密度无显著差异。接受皮质类固醇治疗的患者腰椎骨质疏松患病率为1.4%，低于年龄和性别匹配的白种人报道的患病率。
接受过皮质类固醇治疗的绝经前SLE患者的骨密度测量值显著低于未接受过治疗的患者。骨密度与皮质类固醇治疗呈负相关，但与疾病活动度无关。基于腰椎骨密度的骨质疏松患病率低于白种人报道的患病率。
