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Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1995 Apr;54(4):274–276. doi: 10.1136/ard.54.4.274

Loss of bone mineral density in premenopausal women with systemic lupus erythematosus.

F Formiga 1, I Moga 1, J M Nolla 1, M Pac 1, F Mitjavila 1, D Roig-Escofet 1
PMCID: PMC1005573  PMID: 7763104

Abstract

OBJECTIVE--To evaluate bone mineral density (BMD) in premenopausal patients with systemic lupus erythematosus (SLE). METHODS--We measured BMD by dual energy x ray absorptiometry at lumbar vertebrae L2-4 and at the right femoral neck in 74 premenopausal white patients (mean age 30.8 years) with SLE who were receiving glucocorticoid therapy, and in a control group. RESULTS--The mean cumulative dose of prednisone was 32.5 (SD 28) g. The mean dose at the time of absorptiometry was 13.7 (6.9) mg. BMD was significantly reduced at the spine and at the femoral neck in SLE patients when compared with the control group: L2-4 = 0.943 (0.1) g/cm2 v 1.038 (0.1) g/cm2 (p < 0.001); femoral neck = 0.766 (0.09) g/cm2 v 0.864 (0.1) g/cm2 (p < 0.001). Nine patients (12.1%), but none of the control group, had a BMD less than the reference range. CONCLUSION--BMD in premenopausal patients with SLE was less than that in a control group and less than the reference range of values defining the presence of osteoporosis in 12.1%. We did not find a relationship between BMD and either cumulative or baseline dose of corticosteroid therapy.

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Selected References

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  1. Adinoff A. D., Hollister J. R. Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med. 1983 Aug 4;309(5):265–268. doi: 10.1056/NEJM198308043090502. [DOI] [PubMed] [Google Scholar]
  2. Babini S. M., Arturi A., Marcos J. C., Babini J. C., Iniguez A. M., Morteo O. G. Laxity and rupture of the patellar tendon in systemic lupus erythematosus. Association with secondary hyperparathyroidism. J Rheumatol. 1988 Jul;15(7):1162–1165. [PubMed] [Google Scholar]
  3. Colette C., Monnier L., Pares Herbute N., Blotman F., Mirouze J. Calcium absorption in corticoid treated subjects effects of a single oral dose of calcitriol. Horm Metab Res. 1987 Jul;19(7):335–338. doi: 10.1055/s-2007-1011815. [DOI] [PubMed] [Google Scholar]
  4. Goulding A., Gold E. Effects of chronic prednisolone treatment on bone resorption and bone composition in intact and ovariectomized rats and in ovariectomized rats receiving beta-estradiol. Endocrinology. 1988 Feb;122(2):482–487. doi: 10.1210/endo-122-2-482. [DOI] [PubMed] [Google Scholar]
  5. Hahn T. J., Halstead L. R., Baran D. T. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab. 1981 Jan;52(1):111–115. doi: 10.1210/jcem-52-1-111. [DOI] [PubMed] [Google Scholar]
  6. Kalla A. A., Fataar A. B., Jessop S. J., Bewerunge L. Loss of trabecular bone mineral density in systemic lupus erythematosus. Arthritis Rheum. 1993 Dec;36(12):1726–1734. doi: 10.1002/art.1780361212. [DOI] [PubMed] [Google Scholar]
  7. Klein R. G., Arnaud S. B., Gallagher J. C., Deluca H. F., Riggs B. L. Intestinal calcium absorption in exogenous hypercortisonism. Role of 25-hydroxyvitamin D and corticosteroid dose. J Clin Invest. 1977 Jul;60(1):253–259. doi: 10.1172/JCI108762. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lahita R. G., Bradlow H. L., Fishman J., Kunkel H. G. Abnormal estrogen and androgen metabolism in the human with systemic lupus erythematosus. Am J Kidney Dis. 1982 Jul;2(1 Suppl 1):206–211. [PubMed] [Google Scholar]
  9. Leboff M. S., Wade J. P., Mackowiak S., el-Hajj Fuleihan G., Zangari M., Liang M. H. Low dose prednisone does not affect calcium homeostasis or bone density in postmenopausal women with rheumatoid arthritis. J Rheumatol. 1991 Mar;18(3):339–344. [PubMed] [Google Scholar]
  10. Lukert B. P., Raisz L. G. Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med. 1990 Mar 1;112(5):352–364. doi: 10.7326/0003-4819-112-5-352. [DOI] [PubMed] [Google Scholar]
  11. Reed A., Haugen M., Pachman L. M., Langman C. B. Abnormalities in serum osteocalcin values in children with chronic rheumatic diseases. J Pediatr. 1990 Apr;116(4):574–580. doi: 10.1016/s0022-3476(05)81605-1. [DOI] [PubMed] [Google Scholar]
  12. Reid I. R., Ibbertson H. K. Evidence for decreased tubular reabsorption of calcium in glucocorticoid-treated asthmatics. Horm Res. 1987;27(4):200–204. doi: 10.1159/000180820. [DOI] [PubMed] [Google Scholar]
  13. Richelson L. S., Wahner H. W., Melton L. J., 3rd, Riggs B. L. Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med. 1984 Nov 15;311(20):1273–1275. doi: 10.1056/NEJM198411153112002. [DOI] [PubMed] [Google Scholar]
  14. Rigotti N. A., Neer R. M., Skates S. J., Herzog D. B., Nussbaum S. R. The clinical course of osteoporosis in anorexia nervosa. A longitudinal study of cortical bone mass. JAMA. 1991 Mar 6;265(9):1133–1138. [PubMed] [Google Scholar]
  15. Rüegsegger P., Medici T. C., Anliker M. Corticosteroid-induced bone loss. A longitudinal study of alternate day therapy in patients with bronchial asthma using quantitative computed tomography. Eur J Clin Pharmacol. 1983;25(5):615–620. doi: 10.1007/BF00542348. [DOI] [PubMed] [Google Scholar]
  16. Sambrook P. N., Eisman J. A., Yeates M. G., Pocock N. A., Eberl S., Champion G. D. Osteoporosis in rheumatoid arthritis: safety of low dose corticosteroids. Ann Rheum Dis. 1986 Nov;45(11):950–953. doi: 10.1136/ard.45.11.950. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Seitz M., Hunstein W. Enhanced prostanoid release from monocytes of patients with rheumatoid arthritis and active systemic lupus erythematosus. Ann Rheum Dis. 1985 Jul;44(7):438–445. doi: 10.1136/ard.44.7.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Suzuki Y., Ichikawa Y., Saito E., Homma M. Importance of increased urinary calcium excretion in the development of secondary hyperparathyroidism of patients under glucocorticoid therapy. Metabolism. 1983 Feb;32(2):151–156. doi: 10.1016/0026-0495(83)90221-4. [DOI] [PubMed] [Google Scholar]
  19. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  20. Tanaka Y., Watanabe K., Suzuki M., Saito K., Oda S., Suzuki H., Eto S., Yamashita U. Spontaneous production of bone-resorbing lymphokines by B cells in patients with systemic lupus erythematosus. J Clin Immunol. 1989 Sep;9(5):415–420. doi: 10.1007/BF00917107. [DOI] [PubMed] [Google Scholar]
  21. van den Brink H. R., Lems W. F., van Everdingen A. A., Bijlsma J. W. Adjuvant oestrogen treatment increases bone mineral density in postmenopausal women with rheumatoid arthritis. Ann Rheum Dis. 1993 Apr;52(4):302–305. doi: 10.1136/ard.52.4.302. [DOI] [PMC free article] [PubMed] [Google Scholar]

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