Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital , Helsinki , Finland.
Scand J Rheumatol. 2013;42(5):390-3. doi: 10.3109/03009742.2013.775331. Epub 2013 May 31.
To study risk factors for symptomatic bone fractures in patients with systemic lupus erythematosus (SLE) and to compare the frequency of fractures between SLE patients and population controls.
The study included 222 SLE patients [mean age 47.0 years, disease duration 13.1 years, 204 (92%) women] and 720 population controls living in the metropolitan area of Helsinki. The history of symptomatic bone fractures in SLE patients and controls was recorded by interview, and demographic and clinical data of SLE patients were obtained by interview, clinical examination, and chart review.
A history of at least one symptomatic bone fracture was recorded in 93 (42%) of all 222 patients with SLE. The risk of any fracture in 204 women with SLE compared to controls was 1.8 [95% confidence interval (CI) 1.3-2.4] and fractures in the ankle, hip, and vertebral column were more common than in female controls, with odds ratios (ORs) of 2.0 (95% CI 1.1-3.7), 5.1 (95% CI 1.2-21.5), and 4.0 (95% CI 1.8-8.6), respectively. In 18 men with SLE, compared to male controls, no difference in the frequency of fractures was observed (OR 0.7, 95% CI 0.3-2.0). Risk factors for bone fractures in women with SLE were age (p = 0.008), comorbidity (p = 0.050), and the duration of corticosteroid use (p = 0.025).
Symptomatic bone fractures, especially in the ankle, hip, and vertebral column, are common in women with SLE. Special attention should be paid to preventing fractures in elderly female patients with comorbidities and a long duration of corticosteroid use.
研究系统性红斑狼疮（SLE）患者发生症状性骨骨折的危险因素，并比较 SLE 患者与普通人群骨折发生率的差异。
该研究纳入了 222 名 SLE 患者[平均年龄 47.0 岁，病程 13.1 年，204 名（92%）为女性]和居住在赫尔辛基大都市区的 720 名普通人群对照。通过访谈记录 SLE 患者和对照者的症状性骨骨折史，通过访谈、临床检查和病历回顾获取 SLE 患者的人口统计学和临床数据。
222 名 SLE 患者中，93 名（42%）有至少一次症状性骨骨折史。204 名女性 SLE 患者与对照者相比，任何部位骨折的风险为 1.8（95%可信区间[CI]为 1.3-2.4），且踝、髋和脊柱骨折更为常见，比值比（OR）分别为 2.0（95% CI 为 1.1-3.7）、5.1（95% CI 为 1.2-21.5）和 4.0（95% CI 为 1.8-8.6）。18 名男性 SLE 患者与男性对照者相比，骨折发生率无差异（OR 0.7，95% CI 为 0.3-2.0）。SLE 女性骨折的危险因素包括年龄（p = 0.008）、合并症（p = 0.050）和皮质类固醇使用时间（p = 0.025）。
症状性骨骨折，尤其是踝、髋和脊柱骨折，在女性 SLE 患者中较为常见。对于有合并症和皮质类固醇使用时间长的老年女性患者，应特别注意预防骨折。
