Almehed K, Forsblad d'Elia H, Kvist G, Ohlsson C, Carlsten H
Department of Rheumatology and Inflammation Reserch, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Rheumatology (Oxford). 2007 Jul;46(7):1185-90. doi: 10.1093/rheumatology/kem105. Epub 2007 May 11.
To determine the frequency of osteoporosis and possible risk factors of low bone mineral density (BMD) in women with systemic lupus erythematous (SLE) in western Sweden. In addition, to evaluate if adequate anti-osteoporotic treatment was provided.
BMD was measured at radius, lumbar spine and hip by dual X-ray absorptiometry (DXA). An 'expected' control BMD was calculated for each patient. Simple and multiple linear regression analyses were performed to determine associations between BMD and demographic and disease-related variables.
One hundred and sixty-three women were included. Median age was 47 (20-82) yrs, 89 (55%) were post-menopausal and 85 (52%) were taking glucocorticosteroids. BMD was significantly reduced in all measured sites compared with expected BMD. Thirty-seven (23%), 18 (11%) and 6 (4%) of the patients were osteoporotic in at least one, two and three or more measured locations. Bisphosphonates were used by 23 (27%) of patients taking glucocorticosteroids and 13 (35%) with osteoporosis. High age and low weight or BMI were associated with low BMD in all measured sites. In total hip, high SLICC/American Collage of Rheumatology (ACR), ESR and 'combinations of DMARD' were additional markers of low BMD. High S-creatinine was associated with low BMD in lumbal spine whereas high S-creatinine and CRP were markers in radius.
Women with SLE are at greater risk of osteoporosis compared with controls and few are treated adequately. Factors associated with low BMD in SLE are high age and low weight but also markers of inflammation, impaired kidney function and disease damage, however glucocorticosteroids were not associated.
确定瑞典西部系统性红斑狼疮（SLE）女性骨质疏松症的发生率及低骨密度（BMD）的可能危险因素。此外，评估是否提供了充分的抗骨质疏松治疗。
采用双能X线吸收法（DXA）测量桡骨、腰椎和髋部的骨密度。为每位患者计算“预期”对照骨密度。进行单因素和多因素线性回归分析，以确定骨密度与人口统计学和疾病相关变量之间的关联。
纳入163名女性。中位年龄为47（20 - 82）岁，89名（55%）为绝经后女性，85名（52%）正在服用糖皮质激素。与预期骨密度相比，所有测量部位的骨密度均显著降低。在至少一个、两个和三个或更多测量部位骨质疏松的患者分别为37名（23%）、18名（11%）和6名（4%）。服用糖皮质激素的患者中有23名（27%）使用了双膦酸盐，骨质疏松患者中有13名（35%）使用了双膦酸盐。高龄、低体重或低体重指数与所有测量部位的低骨密度相关。在全髋部，高系统性红斑狼疮国际协作临床诊治规范（SLICC）/美国风湿病学会（ACR）评分、血沉（ESR）和“联合使用改善病情抗风湿药（DMARD）”是低骨密度的额外标志物。高血清肌酐与腰椎低骨密度相关，而高血清肌酐和高C反应蛋白（CRP）是桡骨低骨密度的标志物。
与对照组相比，SLE女性患骨质疏松症的风险更高，且很少得到充分治疗。SLE患者低骨密度相关因素为高龄、低体重，但也包括炎症标志物、肾功能受损和疾病损伤，然而糖皮质激素与之无关。
