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Bone impairment assessed by HR-pQCT in juvenile-onset systemic lupus erythematosus.
Osteoporos Int. 2016 May; 27(5):1839-48.OI

Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT) analysis of female juvenile-onset systemic lupus erythematosus (JoSLE) patients revealed trabecular/cortical bone damage and reduced bone strength primarily at the distal radius compared to healthy controls. We demonstrated for the first time that JoSLE patients with vertebral fracture (VF) present trabecular impairment at the distal radius.

INTRODUCTION

This study investigated the volumetric bone mineral density (vBMD), microarchitecture, and biomechanical features at the distal radius and tibia using HR-pQCT and laboratory bone markers in JoSLE patients compared to controls to determine whether this method discriminates JoSLE patients with or without VF.

METHODS

We compared 56 female JoSLE patients to age- and Tanner-matched healthy controls. HR-pQCT was performed at the distal radius and tibia. Serum levels of the amino-terminal pro-peptide of type I collagen, the C-terminal telopeptide of type I collagen, intact parathormone, sclerostin, and 25-hydroxyvitamin D (25OHD) were evaluated. VFs were analyzed using VFA-dual-energy X-ray absorptiometry (DXA) (Genant's method).

RESULTS

Reduced density and strength parameters and microarchitecture alterations of cortical and trabecular bones were observed in JoSLE patients compared to controls, primarily at the distal radius (p < 0.05). Patients with VF exhibited a significant decrease in trabecular bone parameters solely at the distal radius (Total.BMD, p = 0.034; Trabecular.BMD [Tb.BMD], p = 0.034; bone volume (BV)/trabecular volume (TV), p = 0.034; apparent modulus, p = 0.039) and higher scores for disease damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI), p = 0.002). Bone metabolism markers were similar in all groups. Logistic regression analysis of parameters that were significant in univariate analysis revealed that Tb.BMD (OR 0.98, 95 % CI 0.95-0.99, p = 0.039) and SLICC/ACR-DI (OR 7.37, 95 % CI 1.75-30.97, p = 0.006) were independent risk factors for VF.

CONCLUSION

In conclusion, this study is the first demonstration of bone microstructure and strength deficits in JoSLE patients, particularly at the distal radius. Our results demonstrated that VF was associated with trabecular radius alteration and emphasized the potential detrimental effect of disease damage on this condition.

Authors+Show Affiliations

Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo, 455, 3° Andar, Sala 3193, Sao Paulo, SP, 01246-903, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo, 455, 3° Andar, Sala 3193, Sao Paulo, SP, 01246-903, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo, 455, 3° Andar, Sala 3193, Sao Paulo, SP, 01246-903, Brazil.RDO Diagnosticos Medicos, Sao Paulo, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo, 455, 3° Andar, Sala 3193, Sao Paulo, SP, 01246-903, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av Dr Arnaldo, 455, 3° Andar, Sala 3193, Sao Paulo, SP, 01246-903, Brazil. rosamariarp@yahoo.com.

Pub Type(s)

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

Language

eng

PubMed ID

26694597

Citation

Paupitz, J A., et al. "Bone Impairment Assessed By HR-pQCT in Juvenile-onset Systemic Lupus Erythematosus." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 27, no. 5, 2016, pp. 1839-48.
Paupitz JA, Lima GL, Alvarenga JC, et al. Bone impairment assessed by HR-pQCT in juvenile-onset systemic lupus erythematosus. Osteoporos Int. 2016;27(5):1839-48.
Paupitz, J. A., Lima, G. L., Alvarenga, J. C., Oliveira, R. M., Bonfa, E., & Pereira, R. M. (2016). Bone impairment assessed by HR-pQCT in juvenile-onset systemic lupus erythematosus. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(5), 1839-48. https://doi.org/10.1007/s00198-015-3461-y
Paupitz JA, et al. Bone Impairment Assessed By HR-pQCT in Juvenile-onset Systemic Lupus Erythematosus. Osteoporos Int. 2016;27(5):1839-48. PubMed PMID: 26694597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone impairment assessed by HR-pQCT in juvenile-onset systemic lupus erythematosus. AU - Paupitz,J A, AU - Lima,G L, AU - Alvarenga,J C, AU - Oliveira,R M, AU - Bonfa,E, AU - Pereira,R M R, Y1 - 2015/12/22/ PY - 2015/02/19/received PY - 2015/12/11/accepted PY - 2015/12/24/entrez PY - 2015/12/24/pubmed PY - 2017/1/11/medline KW - Children and adolescents KW - HR-pQCT KW - Juvenile systemic lupus erythematosus KW - Trabecular KW - Vertebral fractures SP - 1839 EP - 48 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 27 IS - 5 N2 - UNLABELLED: High-resolution peripheral quantitative computed tomography (HR-pQCT) analysis of female juvenile-onset systemic lupus erythematosus (JoSLE) patients revealed trabecular/cortical bone damage and reduced bone strength primarily at the distal radius compared to healthy controls. We demonstrated for the first time that JoSLE patients with vertebral fracture (VF) present trabecular impairment at the distal radius. INTRODUCTION: This study investigated the volumetric bone mineral density (vBMD), microarchitecture, and biomechanical features at the distal radius and tibia using HR-pQCT and laboratory bone markers in JoSLE patients compared to controls to determine whether this method discriminates JoSLE patients with or without VF. METHODS: We compared 56 female JoSLE patients to age- and Tanner-matched healthy controls. HR-pQCT was performed at the distal radius and tibia. Serum levels of the amino-terminal pro-peptide of type I collagen, the C-terminal telopeptide of type I collagen, intact parathormone, sclerostin, and 25-hydroxyvitamin D (25OHD) were evaluated. VFs were analyzed using VFA-dual-energy X-ray absorptiometry (DXA) (Genant's method). RESULTS: Reduced density and strength parameters and microarchitecture alterations of cortical and trabecular bones were observed in JoSLE patients compared to controls, primarily at the distal radius (p < 0.05). Patients with VF exhibited a significant decrease in trabecular bone parameters solely at the distal radius (Total.BMD, p = 0.034; Trabecular.BMD [Tb.BMD], p = 0.034; bone volume (BV)/trabecular volume (TV), p = 0.034; apparent modulus, p = 0.039) and higher scores for disease damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI), p = 0.002). Bone metabolism markers were similar in all groups. Logistic regression analysis of parameters that were significant in univariate analysis revealed that Tb.BMD (OR 0.98, 95 % CI 0.95-0.99, p = 0.039) and SLICC/ACR-DI (OR 7.37, 95 % CI 1.75-30.97, p = 0.006) were independent risk factors for VF. CONCLUSION: In conclusion, this study is the first demonstration of bone microstructure and strength deficits in JoSLE patients, particularly at the distal radius. Our results demonstrated that VF was associated with trabecular radius alteration and emphasized the potential detrimental effect of disease damage on this condition. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26694597/Bone_impairment_assessed_by_HR_pQCT_in_juvenile_onset_systemic_lupus_erythematosus_ L2 - https://doi.org/10.1007/s00198-015-3461-y DB - PRIME DP - Unbound Medicine ER -