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Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus.
J Rheumatol 2012; 39(7):1378-84JR

Abstract

OBJECTIVE

Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure.

METHODS

Women without prior OP fractures were eligible. Bone mineral densities at the hip, spine, and femoral neck were determined using dual-energy x-ray absorptiometry. OP was determined using World Health Organization definitions for participants aged ≥ 50 years (32.8%), and LBM was defined as Z-scores ≤ -2.0 for those aged < 50 years. For those aged ≥ 40 years (63.5%), the 10-year probabilities of a major fracture (FRAX-Major) and hip fracture (FRAX-Hip) were calculated. FRAX-Major ≥ 20% or Hip ≥ 3% was considered high risk. HSA was done in a subgroup (n = 81) of patients.

RESULTS

The study group was 271 women. Mean (SD) age was 43.8 (13.1) years and SLE duration was 11.6 (10.4) years. OP was diagnosed in 14.6% and LBM in 8.8%. FRAX-Major ≥ 20% was seen in 9 patients (5.3%), of whom 6 were taking OP medications. FRAX-Hip ≥ 3% occurred in 16 patients (9.4%), of whom 9 were taking OP medications. Buckling ratio at the left hip narrow neck was positively correlated with FRAX-Major, FRAX-Hip, SLE duration, and duration of corticosteroid use.

CONCLUSION

LBM is prevalent in women with SLE who are < 50 years of age. FRAX may identify those at higher risk of fractures while HSA can assess bone structure noninvasively.

Authors+Show Affiliations

Division of Health Care and Outcome Research, Toronto Western Research Institute, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22660811

Citation

Lee, Jennifer J Y., et al. "Ten-year Absolute Fracture Risk and Hip Bone Strength in Canadian Women With Systemic Lupus Erythematosus." The Journal of Rheumatology, vol. 39, no. 7, 2012, pp. 1378-84.
Lee JJ, Aghdassi E, Cheung AM, et al. Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus. J Rheumatol. 2012;39(7):1378-84.
Lee, J. J., Aghdassi, E., Cheung, A. M., Morrison, S., Cymet, A., Peeva, V., ... Fortin, P. R. (2012). Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus. The Journal of Rheumatology, 39(7), pp. 1378-84. doi:10.3899/jrheum.111589.
Lee JJ, et al. Ten-year Absolute Fracture Risk and Hip Bone Strength in Canadian Women With Systemic Lupus Erythematosus. J Rheumatol. 2012;39(7):1378-84. PubMed PMID: 22660811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus. AU - Lee,Jennifer J Y, AU - Aghdassi,Elaheh, AU - Cheung,Angela M, AU - Morrison,Stacey, AU - Cymet,Anne, AU - Peeva,Valentina, AU - Neville,Carolyn, AU - Hewitt,Sara, AU - DaCosta,Deborah, AU - Pineau,Christian, AU - Pope,Janet, AU - Fortin,Paul R, Y1 - 2012/06/01/ PY - 2012/6/5/entrez PY - 2012/6/5/pubmed PY - 2012/12/10/medline SP - 1378 EP - 84 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 39 IS - 7 N2 - OBJECTIVE: Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure. METHODS: Women without prior OP fractures were eligible. Bone mineral densities at the hip, spine, and femoral neck were determined using dual-energy x-ray absorptiometry. OP was determined using World Health Organization definitions for participants aged ≥ 50 years (32.8%), and LBM was defined as Z-scores ≤ -2.0 for those aged < 50 years. For those aged ≥ 40 years (63.5%), the 10-year probabilities of a major fracture (FRAX-Major) and hip fracture (FRAX-Hip) were calculated. FRAX-Major ≥ 20% or Hip ≥ 3% was considered high risk. HSA was done in a subgroup (n = 81) of patients. RESULTS: The study group was 271 women. Mean (SD) age was 43.8 (13.1) years and SLE duration was 11.6 (10.4) years. OP was diagnosed in 14.6% and LBM in 8.8%. FRAX-Major ≥ 20% was seen in 9 patients (5.3%), of whom 6 were taking OP medications. FRAX-Hip ≥ 3% occurred in 16 patients (9.4%), of whom 9 were taking OP medications. Buckling ratio at the left hip narrow neck was positively correlated with FRAX-Major, FRAX-Hip, SLE duration, and duration of corticosteroid use. CONCLUSION: LBM is prevalent in women with SLE who are < 50 years of age. FRAX may identify those at higher risk of fractures while HSA can assess bone structure noninvasively. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/22660811/Ten_year_absolute_fracture_risk_and_hip_bone_strength_in_Canadian_women_with_systemic_lupus_erythematosus_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=22660811 DB - PRIME DP - Unbound Medicine ER -