中国狼疮肾炎患者骨质疏松症的患病率及相关危险因素：一项横断面研究。

Prevalence and risk factors of osteoporosis in lupus nephritis patients in China: a cross-sectional study.

机构信息

Department of Nephrology, Tongji hospital affiliated to Tongji medical college, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Nutrition, Tongji hospital affiliated to Tongji medical college, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

BMC Nephrol. 2024 Nov 27;25(1):428. doi: 10.1186/s12882-024-03882-7.

DOI:10.1186/s12882-024-03882-7

PMID:39604881

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11604019/

Abstract

BACKGROUND

Osteoporosis is a significant concern among individuals with lupus nephritis (LN), with reported prevalence rates exhibiting considerable variation. This study investigates the prevalence and identifies risk factors contributing to osteoporosis in premenopausal and postmenopausal LN patients, addressing the paucity of data specific to the Chinese population.

METHODS

This cross-sectional study enrolled patients with renal biopsy-proven LN, who underwent bone mineral density (BMD) measurements using dual X-ray absorptiometry at the lumbar spine, total hip, and femoral neck. The study was conducted at Tongji hospital from May 2011 to June 2018.

RESULTS

A total of 130 patients were evaluated, with a mean age of 46.2 ± 12.9 years, including 2 males and 128 females. A significant majority, 52.3% (n = 67) of the female patients, were identified as postmenopausal. BMD measurements revealed that 40.0% of patients had osteoporosis in at least one site. The spearman rank correlation of BMD with clinical characteristics indicated that age at menopause, weight, height, and body mass index were positively correlated with BMD, while age, age at diagnosis of LN, and menopause duration were negatively correlated with BMD in lumbar spine, total hip, and/or femoral neck. Multivariable linear regression analysis demonstrated that body mass index was positively associated with BMD, whereas disease duration and menopause duration were negatively associated with BMD in all and postmenopausal patients. Postmenopausal patients consistently had a higher prevalence of osteoporosis across all measured sites. Factors such as older age, lower weight, and the absence of bisphosphonates therapy were independently associated with an increased risk of osteoporosis in LN patients.

CONCLUSION

Our findings underscore a substantial prevalence of osteoporosis in LN patients, especially among postmenopausal individuals. The study identifies older age, lower weight, and absence of bisphosphonates treatment as risk factors for osteoporosis in this patient population.

摘要

背景

骨质疏松症是狼疮肾炎（LN）患者的一个重要关注点，报告的患病率存在很大差异。本研究调查了绝经前和绝经后 LN 患者骨质疏松症的患病率，并确定了导致骨质疏松症的危险因素，旨在解决特定于中国人群的数据不足的问题。

方法

这项横断面研究纳入了经肾活检证实的 LN 患者，他们在 2011 年 5 月至 2018 年 6 月期间在同济医院接受了双能 X 线吸收法腰椎、全髋和股骨颈的骨密度（BMD）测量。

结果

共评估了 130 名患者，平均年龄为 46.2±12.9 岁，其中 2 名男性，128 名女性。大多数女性患者（52.3%，n=67）被确定为绝经后。BMD 测量显示，至少有一个部位骨质疏松症的患者占 40.0%。BMD 与临床特征的斯皮尔曼等级相关分析表明，绝经年龄、体重、身高和体重指数与 BMD 呈正相关，而年龄、LN 诊断年龄和绝经持续时间与腰椎、全髋和/或股骨颈的 BMD 呈负相关。多变量线性回归分析表明，体重指数与 BMD 呈正相关，而疾病持续时间和绝经持续时间与所有和绝经后患者的 BMD 呈负相关。绝经后患者在所有测量部位的骨质疏松症患病率均较高。年龄较大、体重较低和未接受双膦酸盐治疗等因素与 LN 患者骨质疏松症的风险增加独立相关。