Assessment of the effect of oral corticosteroids on bone mineral density in systemic lupus erythematosus: a preliminary study with dual energy x ray absorptiometry.

Dhillon, Veena; Davies, Melanie; Hall, M. L.; Round, J M; Ell, Peter J.; Jacobs, H. S.; Snaith, M L; Isenberg, David

doi:10.1136/ard.49.8.624

Cited by 78 publications

(48 citation statements)

References 13 publications

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“…Steroids are a mainstay drug therapy in JDM and are a well-recognized cause of osteoporosis in other rheumatic diseases (17)(18)(19)(20)(21)(22)(23). Differently from other reports, our study showed that in children with JDM there is no significant correlation between bone mass and steroid use, a fact possibly due to the small number of patients included in our study.…”

Section: Discussioncontrasting

confidence: 56%

Bone mineral density of Brazilian girls with juvenile dermatomyositis

Castro

Terreri

Szejnfeld

et al. 2005

Braz J Med Biol Res

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We measured bone mineral density (BMD) in girls with juvenile dermatomyositis (JDM) considering multiple factors in order to determine if it could be used as a predictor of reduction in bone mass. A cross-sectional study of lumbar spine BMD (L2-L4) was conducted on 10 girls aged 7-16 years with JDM. A group of 20 age-matched healthy girls was used as control. Lumbar spine BMD was measured by dualenergy X-ray absorptiometry. Weight, height and pubertal Tanner stage were determined in all patients and controls. Duration of disease and mean daily and cumulative steroid doses were calculated for all patients on the basis of their medical charts. JDM activity was determined on the basis of the presence of muscle weakness, cutaneous vasculitis and/or elevation of serum concentration of one or more skeletal muscle enzymes. Seven patients demonstrated osteopenia or osteoporosis. Lumbar BMD was significantly lower in the JDM patients than the age-matched healthy control girls (0.712 vs 0.878, respectively; Student t-test, P = 0.041). No significant correlation between BMD and age, height, Tanner stage, disease duration, corticosteroid use, or disease activity was observed in JDM girls, but a correlation was observed between BMD and weight (Pearson's correlation coefficient, r = 0.802). Patients with JDM may be at risk for a significant reduction in BMD that might contribute to further skeletal fragility. Our results suggest that reduced bone mass in JDM may be related to other intrinsic mechanisms in addition to steroid treatment and some aspects of the disease itself may contribute to this condition.

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Section: Discussioncontrasting

confidence: 56%

Bone mineral density of Brazilian girls with juvenile dermatomyositis

Castro

Terreri

Szejnfeld

et al. 2005

Braz J Med Biol Res

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“…Multiple causes have been proposed to contribute to osteopenia, including limited physical activity, immobility, limited exposure to sunlight, systemic inflammation, corticosteroid use, delay in pubertal development, inadequate dietary intake of calcium and vitamins, and renal insufficiency (3,(5)(6)(7)(8)(9)(10). Although there is no consensus about the extent of the impact of these factors on bone mineral density (BMD) in children with rheumatic diseases, it is important to understand their implications in order to plan further strategies to prevent and treat bone disease in these children.…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density in juvenile systemic lupus erythematosus

Castro

Terreri

Szejnfeld

et al. 2002

Braz J Med Biol Res

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We evaluated spine bone mineral density (BMD) in Brazilian children with juvenile systemic lupus erythematosus (JSLE) in order to detect potential predictors of reduction in bone mass. A cross-sectional study of BMD at the lumbar spine level (L2-L4) was conducted on 16 female JSLE patients aged 6-17 years. Thirty-two age-matched healthy girls were used as control. BMD at the lumbar spine was measured by dualenergy X-ray absorptiometry. Weight, height and pubertal Tanner stage were determined in patients and controls. Disease duration, mean daily steroid doses, mean cumulative steroid doses and JSLE activity measured by the systemic lupus erythematosus disease activity index (SLEDAI) were determined for all JSLE patients based on their medical charts. All parameters were used as potential determinant factors for bone loss. Lumbar BMD tended to be lower in the JSLE patients, however, this difference was not statistically significant (P = 0.10). No significant correlation was observed in JSLE girls between BMD and age, height, Tanner stage, disease duration, corticosteroid use or disease activity. We found a weak correlation between BMD and weight (r = 0.672). In the JSLE group we found no significant parameters to correlate with reduced bone mass. Disease activity and mean cumulative steroid doses were not related to BMD values. We did not observe reduced bone mass in female JSLE.

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“…to date, low BMD has been particularly associated with patients treated with corticosteroids [4,5]. the predominant trabecular loss in corticosteroid-treated Sle patients may be partially explained by the effects of this therapy on mineral bone.…”

Section: Discussionmentioning

confidence: 95%

“…Previous cross-sectional studies have demonstrated that older age, postmenopausal state, low body mass index, longer Sle disease duration, organ damage, impaired renal function, markers of inflammation, low 25-hydroxyvitamin D (25(OH) D) serum levels, and number of deliveries are risk factors for low bone mass density (BMD) [4]. Regardless to the Sle therapy, some studies with Sle patients had shown corticosteroid-induced bone loss [4], but others failed to detect any difference [5,6]. Disease damage and disease severity had been associated with bone loss in the lupus population [6,7].…”

Section: Introductionmentioning

confidence: 95%

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

et al. 2014

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Studies have found an increase in bone loss and fracture in individuals with systemic lupus erythematosus (SLE) compared with general population. The aim of this study was to describe the prevalence of osteopenia, osteoporosis, and fragility fractures and to find potential predictors of bone loss in our cohort of SLE patients. We performed a cross-sectional study and collected 67 bone density measurements (BMD) of our SLE patients. We also collected sociodemographic data, 25-OH-vitamin D levels, serological markers, activity index, SLE cumulative damage index, and pharmacologic treatment. Sixty-seven consecutive BMD from SLE patients were assessed. Osteopenia was found in 28-46% of SLE patients. Osteoporosis ranged from 3 to 6%[corrected]. The only statistically significant correlation we found was between weight and height with total hip and femoral neck BMD (p < 0.05). The most frequent BMD-affected site was at the femoral neck, showing osteopenia in 40.3% [corrected] of SLE patients. Osteoporosis was found in up to 6% [corrected] of SLE patients. We found no predictors of bone loss in relation to the disease activity or its treatment. Fragility fractures were seen in 4.4% of SLE patients. All patients with fragility fractures showed osteopenia at BMD. There is a high prevalence of bone loss in SLE patients, since up to 40% [corrected] of SLE patients showed low BMD. Total hip and femoral neck osteopenia were the most frequent findings correlated with low BMI. We found a lower prevalence of fragility fractures compared with other series.

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Assessment of the effect of oral corticosteroids on bone mineral density in systemic lupus erythematosus: a preliminary study with dual energy x ray absorptiometry.

Cited by 78 publications

References 13 publications

Bone mineral density of Brazilian girls with juvenile dermatomyositis

Bone mineral density of Brazilian girls with juvenile dermatomyositis

Bone mineral density in juvenile systemic lupus erythematosus

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

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