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Childhood-onset disease carries a higher risk of low bone mineral density in an adult population of systemic lupus erythematosus.
Rheumatology (Oxford). 2012 Mar; 51(3):468-75.R

Abstract

OBJECTIVE

To study the BMD of patients with SLE according to the age of disease onset.

METHODS

Consecutive SLE patients were screened for BMD at the hip, lumbar spine and whole body by the dual-energy X-ray absorptiometry (DXA). Comparison was made between patients who had disease onset in childhood (<18 years) and adulthood (≥18 years). Factors associated with low BMD were studied by linear regression.

RESULTS

A total of 395 SLE patients were studied (94% women; 11% childhood-onset disease). Osteoporosis of the lumbar spine and the hip/femoral neck was present in 20 and 10% of the patients, respectively. Childhood-onset SLE patients were less likely to be post-menopausal, but had significantly lower BMI, longer SLE duration and a higher frequency of ever use of high-dose CSs, CYC and AZA. Despite a significantly younger age, the BMD of the hip, femoral neck and lumbar spine was significantly lower in childhood- than adult-onset SLE patients. In linear regression models, childhood-onset disease was an independent factor for lower BMD at the lumbar spine (β = -0.18; P = 0.002), hip (β = -0.20; P = 0.001) and femoral neck (β = -0.16; P = 0.01) after adjustment for age, sex, BMI, smoking, menopause, SLE duration and damage index, duration and current dose of prednisolone treatment and the ever use of high-dose glucocorticoids, other immunosuppressive agents, calcium, vitamin D and the bisphosphonates.

CONCLUSIONS

In adult SLE patients, childhood-onset disease carries a higher risk of osteoporosis, which may possibly be related to a higher cumulative dose of glucocorticoids used for more active disease and failure to achieve a normal peak bone mass during puberty.

Authors+Show Affiliations

Department of Medicine, Tuen Mun Hospital, New Territories, Hong Kong, SAR, China. ccmok2005@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22096013

Citation

Mok, Chi Chiu, et al. "Childhood-onset Disease Carries a Higher Risk of Low Bone Mineral Density in an Adult Population of Systemic Lupus Erythematosus." Rheumatology (Oxford, England), vol. 51, no. 3, 2012, pp. 468-75.
Mok CC, Wong SN, Ma KM. Childhood-onset disease carries a higher risk of low bone mineral density in an adult population of systemic lupus erythematosus. Rheumatology (Oxford). 2012;51(3):468-75.
Mok, C. C., Wong, S. N., & Ma, K. M. (2012). Childhood-onset disease carries a higher risk of low bone mineral density in an adult population of systemic lupus erythematosus. Rheumatology (Oxford, England), 51(3), 468-75. https://doi.org/10.1093/rheumatology/ker306
Mok CC, Wong SN, Ma KM. Childhood-onset Disease Carries a Higher Risk of Low Bone Mineral Density in an Adult Population of Systemic Lupus Erythematosus. Rheumatology (Oxford). 2012;51(3):468-75. PubMed PMID: 22096013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood-onset disease carries a higher risk of low bone mineral density in an adult population of systemic lupus erythematosus. AU - Mok,Chi Chiu, AU - Wong,Sik Nin, AU - Ma,Kwok Man, Y1 - 2011/11/16/ PY - 2011/11/19/entrez PY - 2011/11/19/pubmed PY - 2012/4/20/medline SP - 468 EP - 75 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 51 IS - 3 N2 - OBJECTIVE: To study the BMD of patients with SLE according to the age of disease onset. METHODS: Consecutive SLE patients were screened for BMD at the hip, lumbar spine and whole body by the dual-energy X-ray absorptiometry (DXA). Comparison was made between patients who had disease onset in childhood (<18 years) and adulthood (≥18 years). Factors associated with low BMD were studied by linear regression. RESULTS: A total of 395 SLE patients were studied (94% women; 11% childhood-onset disease). Osteoporosis of the lumbar spine and the hip/femoral neck was present in 20 and 10% of the patients, respectively. Childhood-onset SLE patients were less likely to be post-menopausal, but had significantly lower BMI, longer SLE duration and a higher frequency of ever use of high-dose CSs, CYC and AZA. Despite a significantly younger age, the BMD of the hip, femoral neck and lumbar spine was significantly lower in childhood- than adult-onset SLE patients. In linear regression models, childhood-onset disease was an independent factor for lower BMD at the lumbar spine (β = -0.18; P = 0.002), hip (β = -0.20; P = 0.001) and femoral neck (β = -0.16; P = 0.01) after adjustment for age, sex, BMI, smoking, menopause, SLE duration and damage index, duration and current dose of prednisolone treatment and the ever use of high-dose glucocorticoids, other immunosuppressive agents, calcium, vitamin D and the bisphosphonates. CONCLUSIONS: In adult SLE patients, childhood-onset disease carries a higher risk of osteoporosis, which may possibly be related to a higher cumulative dose of glucocorticoids used for more active disease and failure to achieve a normal peak bone mass during puberty. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/22096013/Childhood_onset_disease_carries_a_higher_risk_of_low_bone_mineral_density_in_an_adult_population_of_systemic_lupus_erythematosus_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/ker306 DB - PRIME DP - Unbound Medicine ER -