High prevalence of vertebral deformity in premenopausal systemic lupus                 erythematosus patients

Borba, V Z Cochenski; Matos, Patricia Girio; Viana, Paulo; Fernandes, Artur da Rocha Corrêa; Sato, Emília Inoue; Lazaretti-Castro, Marise

doi:10.1191/0961203305lu2154oa

Cited by 58 publications

(54 citation statements)

References 23 publications

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“…In other rheumatic autoimmune diseases, fragility fractures have been described. In this way, lupus patients demonstrate bone alteration that varies from 5.0 to 26.1% [25][26][27][28][29]. Furthermore, in a large rheumatoid arthritis study, the authors found an increase in hip fractures, and this alteration was associated with longer disease duration, presence of at least one deformed joint, lower age and weight, and BMD [30].…”

Section: Discussionmentioning

confidence: 87%

High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis

et al. 2011

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Bone mass was only previously studied in juvenile dermatomyositis/polymyositis (DM/PM) patients. Therefore, the objective this study was to evaluate the prevalence of osteoporosis and fractures in adult DM/PM. Forty female DM/PM and 78 age-, gender-, and BMI-matched healthy controls were studied. Medical charts and clinical interviews of all patients were evaluated for demographic and clinical data, including disease activity, cumulative doses of glucocorticoid, menarche and menopause age, and fractures. Bone mineral density (BMD) using dual X-ray absorptiometry (DXA) were measured at lumbar spine (L1-L4) and hip. A decreased BMD in lumbar spine [0.902 (0.136) vs. 0.965 (0.141) g/cm(2), P = 0.022] and femoral neck [0.729 (0.12) vs. 0.784 (0.127) g/cm(2), P = 0.027] was observed in patients compared to controls. In addition, osteoporosis was more frequent in patients than in controls in both lumbar spine (20 vs. 3.8%, P = 0.007) and the femoral neck (27.5 vs. 10.3%, P = 0.016). Moreover, a high prevalence of fractures was found in patients in comparison to healthy subjects (17.9 vs. 5.1%, P = 0.040; OR = 3.92; CI 95%:1.07-14.33). Comparing DM/PM patients with (n = 17) and without (n = 23) osteoporosis/fractures, significant differences were observed regarding age [56.8 (11.9) vs. 48.3 (13.2) years, P = 0.042], weight [62.05 (13.56) vs. 71.51 (11.46) kg, P = 0.022] and frequency of post menopausal women (94.1 vs. 65.2%, P = 0.0002). No differences were observed concerning height, lean mass, total fat mass, disease activity, mean value of creatine kinase, cumulative glucocorticoid dose, or bisphosphonate use. Logistic regression analysis revealed a negative association between the presence of osteoporosis/fractures and weight (OR: 0.92, 95% CI: 0.85-0.98; P = 0.016). This is the first study that analyzed bone mass in adult DM/PM patients and it demonstrated that about one quarter of these patients have osteoporosis/fracture.

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Section: Discussionmentioning

confidence: 87%

High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis

et al. 2011

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“…patients (8,24,49,50) (Table 2). Low BMD (24,49,50), age (24,50), previous use of intravenous methylprednisolone (8), male sex (8), and, surprisingly, higher BMI (50) were associated with vertebral fractures.…”

Section: Fractures and Osteoporosis In Slementioning

confidence: 99%

“…Low BMD (24,49,50), age (24,50), previous use of intravenous methylprednisolone (8), male sex (8), and, surprisingly, higher BMI (50) were associated with vertebral fractures. Importantly, among the patients with vertebral fractures, 29 -35.8% had normal BMD (24,50).…”

Section: Fractures and Osteoporosis In Slementioning

confidence: 99%

Osteoporosis and fractures in systemic lupus erythematosus

Bultink¹

2011

Arthritis Care & Research

104

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“…Prevalence of osteoporosis in SLE patients is between 4% and 22% (15). Bone loss is most prominent in the lumbar spine and is much less evident at the hip joint and can be present at diagnosis prior to the initiation of treatment involvement (14).…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Osteoporosis and inflammation

Lacativa

Farias

2010

Arq Bras Endocrinol Metab

200

138

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SUMMARYSeveral inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, celiac disease, cystic fibrosis and chronic obstructive pulmonary disease have been associated to bone resorption. The link between osteoclast, macrophage colony stimulating factor and pro-inflammatory cytokines, especially tumor necrosis factor-α and interleukin-1 explain the association between inflammation and osteoporosis. These diseases are related to osteoporosis and high fracture risk independent of other risk factors common to inflammatory diseases such as reduced physical activity, poor nutritional status, hypovitaminosis D, decrease in calcium intake and glucocorticoid treatment. Erythrocyte sedimentation rate and C-reactive protein should always be performed, but the indication about when to perform the densitometry test should be analyzed for each disease. Bisphosphonates are nowadays the best choice of therapy but new medications such as denosumab, IL-1 receptor antagonist, and TNF-α antibody have risen as new potential treatments for osteoporosis secondary to inflammation. Arq Bras Endocrinol Metab. 2010;54(2):123-32 Keywords Osteoporosis; inflammation; arthritis, rheumatoid; lupus erythematosus, systemic; interleukin-1; tumor necrosis factor-alpha SUMÁRIO Diversas doenças inflamatórias têm sido associadas à reabsorção óssea, como a artrite reumatoide, o lúpus eritematoso sistêmico, a doença inflamatória intestinal, a doença celíaca, a fibrose cística e a doença pulmonar obstrutiva crônica. A ligação entre osteoclastos, fator estimulador de colônia de macrófagos e citocinas pró-inflamatórias, principalmente o fator de necrose tumoral-α e interleucina-1, explica a associação entre a inflamação e a osteoporose. Essas doenças estão relacionadas com osteoporose e aumento do risco de fratura, independentemente de outros fatores de risco comuns às doenças inflamatórias, tais como redução da atividade física, estado nutricional, hipovitaminose D, diminuição da ingestão de cálcio e uso de glicocorticoides. A velocidade de hemossedimentação e proteína C-reativa devem ser sempre realizadas, mas a indicação do exame de densitometria óssea deve ser analisada em cada doen ça. Os bisfosfonatos são atualmente a melhor opção de terapia, mas novos medicamentos, tais como denosumabe, antagonista do receptor de IL-1 e anticorpos anti-TNF-α, surgem como novos potenciais tratamentos para a osteoporose secundária à inflamação. Arq Bras Endocrinol Metab. 2010;54(2):123-32 Descritores Osteoporose; inflamação; artrite reumatoide; lúpus eritematoso sistêmico; interleucina-1; fator de necrose tumoral-alfa

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High prevalence of vertebral deformity in premenopausal systemic lupus erythematosus patients

Cited by 58 publications

References 23 publications

High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis

High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis

Osteoporosis and fractures in systemic lupus erythematosus

Osteoporosis and inflammation

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