Yeap S S, Fauzi A R, Kong N C T, Halim A G, Soehardy Z, Rahimah S, Chow S K, Goh E M L
Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Lupus. 2009 Feb;18(2):178-81. doi: 10.1177/0961203308094995.
The aim of this study was to assess the bone mineral density (BMD) of premenopausal patients with systemic lupus erythematosus (SLE) on corticosteroids (CS) and to determine the influence of CS and other risk factors on BMD. A total of 98 premenopausal patients with SLE were recruited from outpatient clinics in two teaching hospitals. Risk factors for osteoporosis were determined, and BMD was measured using dual-energy x-ray absorptiometry. The mean age of the patients was 30.05 +/- 7.54 years. The mean dose of prednisolone at time of BMD measurement was 18.38 +/- 10.85 mg daily. Median duration of CS use was 2.5 years (range 0-20). Median cumulative dose of CS was 9.04 g (range 0.28-890.0). Six patients (6.1%) had osteoporosis, 41 (41.9%) had osteopenia and 51 (52.0%) had normal BMD. Lumbar spine T score correlated with cumulative CS dose (P = 0.019). Duration of CS intake correlated with femoral neck T score (P = 0.04) and trochanter T score (P = 0.008). There was no correlation between BMD and race, SLE Disease Activity Index score, smoking and self-reported calcium intake or exercise. Only 52% of these patients had normal BMD. The duration and cumulative dose of CS intake was significantly correlated to BMD, but not the other commonly assessed risk factors. These findings suggest that premenopausal patients with SLE on CS should have their BMD measured at regular intervals to fully assess their osteoporosis risk.
本研究旨在评估使用皮质类固醇（CS）的绝经前系统性红斑狼疮（SLE）患者的骨矿物质密度（BMD），并确定CS及其他风险因素对BMD的影响。从两家教学医院的门诊招募了总共98例绝经前SLE患者。确定骨质疏松的风险因素，并使用双能X线吸收法测量BMD。患者的平均年龄为30.05±7.54岁。BMD测量时泼尼松龙的平均剂量为每日18.38±10.85mg。CS使用的中位持续时间为2.5年（范围0 - 20年）。CS的中位累积剂量为9.04g（范围0.28 - 890.0g）。6例患者（6.1%）患有骨质疏松症，41例（41.9%）患有骨质减少症，51例（52.0%）BMD正常。腰椎T值与CS累积剂量相关（P = 0.019）。CS摄入持续时间与股骨颈T值相关（P = 0.04）和大转子T值相关（P = 0.008）。BMD与种族、SLE疾病活动指数评分、吸烟以及自我报告的钙摄入量或运动量之间无相关性。这些患者中只有52%的BMD正常。CS摄入的持续时间和累积剂量与BMD显著相关，但与其他常用评估的风险因素无关。这些发现表明，使用CS的绝经前SLE患者应定期测量BMD，以全面评估其骨质疏松风险。
