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. 2003;76(2):45–54.

The effect of long-term glucocorticoids on bone metabolism in systemic lupus erythematosus patients: the prevalence of its anti-inflammatory action upon bone resorption.

Izabela Korczowska 1, Anna Olewicz-Gawlik 1, Paweł Hrycaj 1, Jan Lacki 1
PMCID: PMC2582697  PMID: 15369631

Abstract

The study was made to evaluate bone turnover in systemic lupus erythematosus (SLE) patients undergoing long-term glucocorticoid therapy. Thirty-eight female patients with established SLE were compared with a control group consisting from 160 age-matched healthy women. Serum concentrations of proinflammatory cytokines: interleukin-1alpha, interleukin-6, tumor necrosis factor-alpha, granulocyte-macrophage colony stimulating factor (GM-CSF) and some biochemical markers of osteoporosis (osteocalcin, total and bone alkaline phosphatase, procollagen type I carboxyterminal propeptide, carboxyterminal telopeptides of type I collagen--CTx) were measured. Additionally, morning urine excretions of deoxypyridinoline and calcium/creatinin ratios were determined. The forearm densitometry (DXA) was performed in all patients. Bone mineral content (BMC) and bone mineral density (BMD) in the SLE group was not significantly different from the controls, and no relationship was found between the glucocorticoid exposure and the BMC/BMD. However, biochemical markers of bone resorption--CTx and calcium/creatinin ratio--were significantly increased in the patient group. Our results suggest that BMD/BMC is preserved in glucocorticoid-treated SLE patients despite accelerated bone turnover.

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Selected References

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  1. Adachi J. D., Olszynski W. P., Hanley D. A., Hodsman A. B., Kendler D. L., Siminoski K. G., Brown J., Cowden E. A., Goltzman D., Ioannidis G. Management of corticosteroid-induced osteoporosis. Semin Arthritis Rheum. 2000 Feb;29(4):228–251. doi: 10.1016/s0049-0172(00)80011-6. [DOI] [PubMed] [Google Scholar]
  2. Als O. S., Christiansen C., Hellesen C. Prevalence of decreased bone mass in rheumatoid arthritis. Relation to anti-inflammatory treatment. Clin Rheumatol. 1984 Jun;3(2):201–208. doi: 10.1007/BF02030755. [DOI] [PubMed] [Google Scholar]
  3. Beauparlant P., Hiscott J. Biological and biochemical inhibitors of the NF-kappa B/Rel proteins and cytokine synthesis. Cytokine Growth Factor Rev. 1996 Aug;7(2):175–190. doi: 10.1016/1359-6101(96)00020-2. [DOI] [PubMed] [Google Scholar]
  4. Bog-Hansen T. C. Crossed immuno-affinoelectrophoresis. An analytical method to predict the result of affinity chromatography. Anal Biochem. 1973 Dec;56(2):480–488. doi: 10.1016/0003-2697(73)90215-7. [DOI] [PubMed] [Google Scholar]
  5. Chatham W. W., Kimberly R. P. Treatment of lupus with corticosteroids. Lupus. 2001;10(3):140–147. doi: 10.1191/096120301675075008. [DOI] [PubMed] [Google Scholar]
  6. Christiansen C., Riis B. J., Rødbro P. Screening procedure for women at risk of developing postmenopausal osteoporosis. Osteoporos Int. 1990 Oct;1(1):35–40. doi: 10.1007/BF01880414. [DOI] [PubMed] [Google Scholar]
  7. Cunnane G., Lane N. E. Steroid-induced osteoporosis in systemic lupus erythematosus. Rheum Dis Clin North Am. 2000 May;26(2):311-29, vi-vii. doi: 10.1016/s0889-857x(05)70140-x. [DOI] [PubMed] [Google Scholar]
  8. Davas E. M., Tsirogianni A., Kappou I., Karamitsos D., Economidou I., Dantis P. C. Serum IL-6, TNFalpha, p55 srTNFalpha, p75srTNFalpha, srIL-2alpha levels and disease activity in systemic lupus erythematosus. Clin Rheumatol. 1999;18(1):17–22. doi: 10.1007/s100670050045. [DOI] [PubMed] [Google Scholar]
  9. Frauman A. G. An overview of the adverse reactions to adrenal corticosteroids. Adverse Drug React Toxicol Rev. 1996 Nov;15(4):203–206. [PubMed] [Google Scholar]
  10. Fujita T., Matsui T., Nakao Y., Shiozawa S., Imai Y. Cytokines and osteoporosis. Ann N Y Acad Sci. 1990;587:371–375. doi: 10.1111/j.1749-6632.1990.tb00178.x. [DOI] [PubMed] [Google Scholar]
  11. Gabay C., Roux-Lombard P., de Moerloose P., Dayer J. M., Vischer T., Guerne P. A. Absence of correlation between interleukin 6 and C-reactive protein blood levels in systemic lupus erythematosus compared with rheumatoid arthritis. J Rheumatol. 1993 May;20(5):815–821. [PubMed] [Google Scholar]
  12. Hachulla E., Cortet B. Prévenir et traiter l'ostéoporose cortico-induite. Rev Med Interne. 1998 Jul;19(7):492–500. doi: 10.1016/s0248-8663(99)80005-8. [DOI] [PubMed] [Google Scholar]
  13. Hansen M., Halberg P., Kollerup G., Pedersen-Zbinden B., Hørslev-Petersen K., Hyldstrup L., Lorenzen I. Bone metabolism in patients with systemic lupus erythematosus. Effect of disease activity and glucocorticoid treatment. Scand J Rheumatol. 1998;27(3):197–206. doi: 10.1080/030097498440813. [DOI] [PubMed] [Google Scholar]
  14. Houssiau F. A., Lefebvre C., Depresseux G., Lambert M., Devogelaer J. P., Nagant de Deuxchaisnes C. Trabecular and cortical bone loss in systemic lupus erythematosus. Br J Rheumatol. 1996 Mar;35(3):244–247. doi: 10.1093/rheumatology/35.3.244. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Kanis J. A. Osteoporosis and osteopenia. J Bone Miner Res. 1990 Mar;5(3):209–211. doi: 10.1002/jbmr.5650050302. [DOI] [PubMed] [Google Scholar]
  17. Lacki J. K., Leszczynski P., Kelemen J., Müller W., Mackiewicz S. H. Cytokine concentration in serum of lupus erythematosus patients: the effect on acute phase response. J Med. 1997;28(1-2):99–107. [PubMed] [Google Scholar]
  18. Nelson A. M., Conn D. L. Series on pharmacology in practice. 9. Glucocorticoids in rheumatic disease. Mayo Clin Proc. 1980 Dec;55(12):758–769. [PubMed] [Google Scholar]
  19. Niedermeier A., Messer G. Glukokortikosteroidinduzierte Osteoporose. Eine zu wenig beachtete Folge der langfristigen Behandlung von Autoimmunerkrankungen. Hautarzt. 2001 Jun;52(6):477–483. doi: 10.1007/s001050000098. [DOI] [PubMed] [Google Scholar]
  20. Olbricht T., Benker G. Glucocorticoid-induced osteoporosis: pathogenesis, prevention and treatment, with special regard to the rheumatic diseases. J Intern Med. 1993 Sep;234(3):237–244. doi: 10.1111/j.1365-2796.1993.tb00738.x. [DOI] [PubMed] [Google Scholar]
  21. Robak E., Sysa-Jedrzejewska A., Dziankowska B., Torzecka D., Chojnowski K., Robak T. Association of interferon gamma, tumor necrosis factor alpha and interleukin 6 serum levels with systemic lupus erythematosus activity. Arch Immunol Ther Exp (Warsz) 1998;46(6):375–380. [PubMed] [Google Scholar]
  22. Sinigaglia L., Varenna M., Binelli L., Zucchi F., Ghiringhella D., Gallazzi M., Limonta M., Zeni S., Fantini F. Determinants of bone mass in systemic lupus erythematosus: a cross sectional study on premenopausal women. J Rheumatol. 1999 Jun;26(6):1280–1284. [PubMed] [Google Scholar]
  23. Teichmann J., Lange U., Stracke H., Federlin K., Bretzel R. G. Bone metabolism and bone mineral density of systemic lupus erythematosus at the time of diagnosis. Rheumatol Int. 1999;18(4):137–140. doi: 10.1007/s002960050072. [DOI] [PubMed] [Google Scholar]

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