Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Rheumatol Int. 2011 Mar;31(3):365-76. doi: 10.1007/s00296-009-1244-5. Epub 2009 Dec 18.
To examine the prevalence of and risk factors for low bone mineral density (BMD) (osteoporosis or osteopenia) in Japanese female patients with systemic lupus erythematosus (SLE). We performed BMD measurements by dual X-ray absorptiometry at the lumbar spine and the hip and collected basic and lifestyle-related, clinical and treatment characteristics among 58 SLE patients. Odds ratios (ORs) and their 95% confidence intervals (CIs) were assessed for associations between low BMD and selected factors among SLE patients. The mean BMD ± SD was 0.90 ± 0.17 g/cm(2) at the lumbar spine and 0.76 ± 0.17 g/cm(2) at the hip. The prevalence of osteopenia (2.5 SD < T score < 1 SD) was 50.0% and that of osteoporosis (T score < 2.5 SD) was 13.8% in our SLE patients. After adjustment for age and disease duration, we found the number of deliveries (OR = 5.58, 95% CI = 1.31-26.06; P = 0.02) to be a risk factor for overall low BMD (T score < 1 SD) and a maximal dosage of >50 mg/day of oral corticosteroids (OR = 0.25, 95% CI = 0.07-0.91; P = 0.035) as a preventive factor for low BMD at the lumbar spine. Reduced BMD, especially in spinal trabecular bone, was pronounced in Japanese female patients with SLE, particular in those with a history of delivery. A history of high-dose oral corticosteroids was associated with the preservation of BMD at the lumbar spine, however, further study is needed considering the limited sample size.
为了研究日本系统性红斑狼疮(SLE)女性患者低骨密度(BMD)(骨质疏松或骨量减少)的患病率和危险因素。我们对 58 例 SLE 患者的腰椎和髋部进行了双能 X 线吸收法骨密度测量,并收集了基本和生活方式相关的、临床和治疗特征。在 SLE 患者中,评估了低 BMD 与选定因素之间的关联的比值比(OR)及其 95%置信区间(CI)。腰椎的平均 BMD ± SD 为 0.90 ± 0.17 g/cm(2),髋部为 0.76 ± 0.17 g/cm(2)。我们的 SLE 患者中,骨质疏松症(2.5 SD < T 评分 < 1 SD)的患病率为 50.0%,骨质疏松症(T 评分 < 2.5 SD)的患病率为 13.8%。在调整年龄和疾病持续时间后,我们发现分娩次数(OR = 5.58,95%CI = 1.31-26.06;P = 0.02)是整体低 BMD(T 评分 < 1 SD)的危险因素,而>50mg/天的最大口服皮质类固醇剂量(OR = 0.25,95%CI = 0.07-0.91;P = 0.035)是预防腰椎低 BMD 的因素。日本 SLE 女性患者的 BMD 减少,尤其是脊柱松质骨,明显降低,尤其是有分娩史的患者。然而,考虑到样本量有限,需要进一步研究高剂量口服皮质类固醇与腰椎 BMD 保留之间的关系。