Homocysteine, bone mineral density, and fracture risk over 2 years of followup in women with and without systemic lupus erythematosus.

OBJECTIVE

To examine the relationship of baseline homocysteine levels with bone mineral density (BMD) and incidence of fractures over 2 years in women with and without systemic lupus erythematosus (SLE).

METHODS

Women with SLE (n = 100) and without SLE (n = 100) were matched according to age (+/- 5 yrs), race, and menopausal status. Data were collected from 1997 to 2004, including hip, lumbar spine (L-spine), and distal forearm BMD, serum homocysteine levels, and a self-administered questionnaire on osteoporosis risk factors, medications and symptomatic fractures at baseline and 2-year followup. Analyses were performed to compare homocysteine levels, BMD, and incident fractures and to evaluate the relationship of homocysteine with BMD and incident fractures in both groups.

RESULTS

Mean homocysteine +/- SD was higher (p < 0.001) in women with SLE (9.88 +/- 3.8 micromol/l) than in women without SLE (7.98 +/- 2.6 micromol/l). Women with SLE had significantly lower L-spine BMD Z-scores, while hip BMD Z-scores and distal forearm BMD T-scores were nonsignificantly lower than in women without SLE. No significant correlations were observed between homocysteine and BMD in either group. Thirteen women with SLE experienced new fractures, while 4 women without SLE had new fractures over 2 years (p = 0.035); however, there was no association between homocysteine levels and incident fractures in either group.

CONCLUSION

Women with SLE had significantly greater baseline homocysteine, lower L-spine BMD, and more new fractures over 2 years, compared with women without SLE. Homocysteine levels were not significantly associated with BMD and did not predict new fractures in women with or without SLE over 2 years.