The aim: To study the peculiarities of bone mineral density in the Ukrainian population of women of different reproductive age with systemic lupus erythematosus and to evaluate its connection with traditional and specific (typical for systemic lupus erythematosus) risk factors. Materials and methods: A total of 91 women with systemic lupus erythematosus and 29 healthy individuals were examined. Along with the clinical study of the activity and severity of the disease, the serum levels of interleukin-6 were determined by the enzyme immunoassay. The peculiarities of bone mineral density were studied using dual-energy X-ray absorptiometry. The presence of fractures was evaluated by the X-ray method. Results: Patients with systemic lupus erythematosus frequently suffer from reduced bone mineral density. Reduced bone mineral density and the appearance of fragility fractures are associated with patients’ age, disease duration, damage index, inflammatory activity, and cumulative dose of glucocorticoids. Conclusions: Progressive reduced bone mineral density in patients with systemic lupus erythematosus occurs not only during the aging process of a woman, but is also associated with a number of systemic lupus erythematosus – related osteoporosis risk factors.

Background:Osteoporosis and fractures associated with it are considered to be one of the most severe complications of systemic lupus erythematosus (SLE). The role of a systemic inflammatory process, vitamin D deficiency, hypogonadism and peculiarities of disease treatment in reduced bone mineral density (BMD) is being discussed. Even though the frequency of osteoporosis in patients with SLE is being studied extensively by scientists from different countries, data on the peculiarities of bone tissue metabolism and the factors that provoke disorders of bone remodeling in such individuals are quite limited. The association between markers of bone tissue metabolism and BMD, and how they change during an inflammatory process is poorly studied.Objectives:The objective of our research is to study the levels of osteocalcin (OC) and procollagen type I C-terminal propeptide (PICP) in patients with systemic lupus erythematosus and to estimate their association with BMD and inflammatory activity based on the levels of interleukin-6 (IL-6).Methods:A total of 58 women with SLE (the average age was 45.11 ± 1.03 years old) and 29 individuals from the control group (the average age was 46.79 ± 2.30 years old) were examined. The diagnosis of SLE was established on the basis of 2019 EULAR/ACR classification criteria for SLE. Levels of IL-6, OC and PICP in serum were determined by enzyme immunoassay. Changes in BMD of the lumbar spine at the level of L1-L4 and the proximal femur were determined by dual-energy X-ray absorptiometry. In postmenopausal women, the diagnosis of osteoporosis was established by the T-score ≤ -2.5 SD. Osteopenia met T-score from -1 to -2.5 SD. In women of reproductive age, the Z-score was used to determine BMD. Values of the Z-score ≤ -2.0 SD were considered as “below expected range for age”.Results:The average OC level in serum of practically healthy individuals equaled 17.64 ± 0,59 ng/ml, and in patients with SLE it was 13.96 ± 0.40 ng/ml, i.e. it was 20.9% lower. The average PICP level in the control group equaled 107.8 ± 4.28 ng/ml, in the main group it was 92.9 ± 5.01 ng/ml, i.e. 16% lower. Overall, the decrease in the bone turnover markers (PICP and/or OC) was noticed in 28 patients with SLE (48.3%) and only in 4 practically healthy individuals (13.8%).In women with decreased bone turnover markers, the T-score of the lumbar spine and hip was 2.3-2.6 times lower (p < 0.05) than in the group with adequate levels of bone turnover markers. Z-score was also lower among patients with decreased levels of OC and PICP. In this group, the average BMD level was 0.81 ± 0.05 g/cm2and was 13.8% lower than in the group of patients with no signs of bone tissue metabolism disorder – 0.94 ± 0.02 g/cm2. Among the group of women with signs of suppression of biosynthetic processes in bone tissue, there were twice more individuals with decreased BMD. In patients with critically high levels of IL-6 (above 20.0 ng/L), OC level was lower than in patients with high (12.5-20.0 ng/L) and adequate (< 12.5 ng/L) levels of IL-6 (by 17.3 and 19% respectively). The proportion of individuals with low OC levels increased from 31.2% in the last group to 70.6% among patients with critically high levels of IL-6.PICP level was also lower (38.1% and 39.7% respectively) in case of critically high IL-6 levels compared to its high and adequate levels. The proportion of individuals with low PICP levels increased from 6.3% in the group with adequate IL-6 level to 58.8% in the group with critically high IL-6 level.Conclusion:Women with SLE have bone tissue metabolism disorder in the form of decreased bone turnover markers (procollagen type I C-terminal propeptide and osteocalcin) associated with the inflammatory activity. In the group of patients with the signs of suppression of biosynthetic processes in the bone tissue, there were more individuals with decreased BMD.Disclosure of Interests:Sergii Shevchuk Grant/research support from: Celltrion, Inc, Liudmyla Denyshchych: None declared

Introduction: Osteoporosis is frequently diagnosed in patients with systemic lupus erythematosus (SLE). Potential causes and mechanisms of the development of this disease in patients with SLE are still being studied. Aim: To study bone mineral density (BMD) of women with SLE in Ukraine, evaluate its association with the level of bone turnover markers, interleukin-6 (IL-6) and serum estradiol levels. Material and methods: In total, 91 SLE women and 29 healthy individuals were examined. Apart from clinical risk factors for osteoporosis development, the levels of IL-6, bone formation and resorption markers, serum estradiol and their association with reduced BMD were evaluated. The deterioration of BMD was detected by dual-energy X-ray absorptiometry. Results and discussion: Reduced BMD in women with SLE is found in 35.2%. In the study group, 28 women with SLE (48.3%) have decreased levels of bone formation markers, while 30 women (51.7%) have increased bone resorption markers. Imbalance of bone metabolism is highly associated with the severity of the disease, IL-6, and an exposure dose of glucocorticoids. The level of estradiol in women with SLE is 1.8 times lower than in individuals from the control group. The deterioration of the BMD is closely related to the bone turnover disorder, level of IL-6 and estradiol. Conclusions: Independent predictors of BMD disorder in SLE women are levels of osteocalcin and C-terminal telopeptide of type I collagen as well as IL-6 and decreased level of serum estradiol.

BackgroundDecrease in vitamin D levels in patients with systemic lupus erythematosus (SLE) arouses particular interest. Vitamin D levels and their correlation with bone mineral density (BMD) loss are still seen as contradictory.ObjectivesTo study serum vitamin D levels in SLE women and to estimate their correlation with BMD and disease activity.Methods101 SLE women and 30 individuals in a control group participated in the study. The activity of SLE was evaluated by SLEDAI. The average age of patients was 47.12 ± 0.14 years, in the control group it was 46.17 ± 0.12. Serum levels of C-reactive protein (CRP) and 25-hydroxyvitamin D (25(ОН)D) were measured in all participants. Changes in BMD of the lumbar spine and hip were determined by dual-energy X-ray densitometry.ResultsIn patients with SLE, the average level of 25(ОН)D equalled 14.6 ± 1.19 ng/ml, and in the individuals from the control group, it was 1.9 times higher, constituting 24.7 ± 1.32 ng/ml.In SLE women with normal BMD (T score > -1.0 SD) vitamin D deficiency (< 20 ng/ml) was detected in 18.3%. In the group with osteopenia (T-score from -1.0 to -2.5 SD), the proportion of individuals with vitamin D deficiency has increased to 26.7%. In women with osteoporosis (T-score ≤ -2.5 SD), vitamin D deficiency was found in 63.9%. In the group of patients with the maximum CRP level there were only 10% of persons with the optimal (> 30 ng/ml) 25(ОН)D level, 40% had insufficiency (20-30 ng/ml), while deficiency (< 20 ng/ml) was detected in every second patient. Among patients with optimal CRP levels, only every fourth person was diagnosed with vitamin D deficiency, 10% of the individuals had vitamin D insufficiency, while 65% had optimal vitamin D levels. Decrease in vitamin D level was closely associated with SLE activity revealed by SLEDAI (r = -0.44; р < 0.05).ConclusionThe average vitamin D level in SLE women is likely to be lower than that in the control group. Decrease in vitamin D levels was associated with BMD loss and high inflammatory process as well as the disease activity according to CRP and SLEDAI.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.