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Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus.
Arthritis Rheum. 2007 Jun; 56(6):1966-73.AR

Abstract

OBJECTIVE

Studies of adults with systemic lupus erythematosus (SLE) have frequently demonstrated the presence of decreased bone mineral density (BMD). However, there have been few investigations in pediatric patients to date. This study was undertaken to determine the prevalence of low BMD in patients with juvenile SLE and to identify associated risk factors.

METHODS

We studied 64 consecutive patients with juvenile SLE in whom routine dual x-ray absorptiometry (DXA) scanning was performed. Lumbar spine osteopenia was defined as a BMD Z score of < -1 and > or = -2.5, and osteoporosis as a BMD Z score of < -2.5. Decreased hip BMD was defined as a value of < 80%. Data on disease activity, quality of life, disease-related damage, sex, ethnicity, body mass index, age at diagnosis, age at DXA, medication use and duration, clinical features, and puberty status were collected at the time of DXA.

RESULTS

Lumbar spine osteopenia was seen in 24 patients (37.5%) and osteoporosis in 13 (20.3%). Decreased hip BMD was present in 12 patients (18.8%). By univariate analysis, osteopenia was significantly correlated with age, disease duration, duration of corticosteroid use, cumulative corticosteroid dose, azathioprine use, cyclophosphamide use, lupus nephritis, and damage. Two additional variables, mycophenolate mofetil use and class III-IV nephritis, were associated with osteoporosis. Abnormal hip BMD was associated with disease duration, duration of corticosteroid use, and cumulative corticosteroid dose. By multivariate analysis, only disease duration remained in the model for osteoporosis and abnormal hip BMD, while cumulative corticosteroid dose was the variable associated with osteopenia.

CONCLUSION

These results indicate that osteopenia and osteoporosis are common in juvenile SLE and are associated more closely with increased disease duration than with cumulative corticosteroid dose.

Authors+Show Affiliations

Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17530722

Citation

Compeyrot-Lacassagne, Sandrine, et al. "Prevalence and Etiology of Low Bone Mineral Density in Juvenile Systemic Lupus Erythematosus." Arthritis and Rheumatism, vol. 56, no. 6, 2007, pp. 1966-73.
Compeyrot-Lacassagne S, Tyrrell PN, Atenafu E, et al. Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus. Arthritis Rheum. 2007;56(6):1966-73.
Compeyrot-Lacassagne, S., Tyrrell, P. N., Atenafu, E., Doria, A. S., Stephens, D., Gilday, D., & Silverman, E. D. (2007). Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus. Arthritis and Rheumatism, 56(6), 1966-73.
Compeyrot-Lacassagne S, et al. Prevalence and Etiology of Low Bone Mineral Density in Juvenile Systemic Lupus Erythematosus. Arthritis Rheum. 2007;56(6):1966-73. PubMed PMID: 17530722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus. AU - Compeyrot-Lacassagne,Sandrine, AU - Tyrrell,Pascal N, AU - Atenafu,Eshetu, AU - Doria,Andrea S, AU - Stephens,Derek, AU - Gilday,David, AU - Silverman,Earl D, PY - 2007/5/29/pubmed PY - 2007/7/21/medline PY - 2007/5/29/entrez SP - 1966 EP - 73 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 56 IS - 6 N2 - OBJECTIVE: Studies of adults with systemic lupus erythematosus (SLE) have frequently demonstrated the presence of decreased bone mineral density (BMD). However, there have been few investigations in pediatric patients to date. This study was undertaken to determine the prevalence of low BMD in patients with juvenile SLE and to identify associated risk factors. METHODS: We studied 64 consecutive patients with juvenile SLE in whom routine dual x-ray absorptiometry (DXA) scanning was performed. Lumbar spine osteopenia was defined as a BMD Z score of < -1 and > or = -2.5, and osteoporosis as a BMD Z score of < -2.5. Decreased hip BMD was defined as a value of < 80%. Data on disease activity, quality of life, disease-related damage, sex, ethnicity, body mass index, age at diagnosis, age at DXA, medication use and duration, clinical features, and puberty status were collected at the time of DXA. RESULTS: Lumbar spine osteopenia was seen in 24 patients (37.5%) and osteoporosis in 13 (20.3%). Decreased hip BMD was present in 12 patients (18.8%). By univariate analysis, osteopenia was significantly correlated with age, disease duration, duration of corticosteroid use, cumulative corticosteroid dose, azathioprine use, cyclophosphamide use, lupus nephritis, and damage. Two additional variables, mycophenolate mofetil use and class III-IV nephritis, were associated with osteoporosis. Abnormal hip BMD was associated with disease duration, duration of corticosteroid use, and cumulative corticosteroid dose. By multivariate analysis, only disease duration remained in the model for osteoporosis and abnormal hip BMD, while cumulative corticosteroid dose was the variable associated with osteopenia. CONCLUSION: These results indicate that osteopenia and osteoporosis are common in juvenile SLE and are associated more closely with increased disease duration than with cumulative corticosteroid dose. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/17530722/Prevalence_and_etiology_of_low_bone_mineral_density_in_juvenile_systemic_lupus_erythematosus_ L2 - https://doi.org/10.1002/art.22691 DB - PRIME DP - Unbound Medicine ER -