Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Disease Damage Has Deleterious Effect on Trabecualr Bone Microarchitecture in Female Patients with Systemic Lupus Erythematosus On Chronic Corticosteroids.
Tang, Xiao Lin, Zhu, Tracy Y., Tam, Lai Shan, Li, Edmund K.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. It can affect almost all the organs of the body, for example the musculoskeletal system. Patients have higher risk of osteoporosis and fracture than general population. Recently, with advances in high resolution imaging techniques, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), interest in investigating bone microarchitecture as an important role in the development of osteoporosis has increased. We aimed to investigate the effect of various clinical parameters on bone geometry, volumetric density and microarchitecture in female SLE patients on chronic corticosteroids using HR-pQCT.
One hundred and twenty Chinese females with SLE on long-term corticosteroids, with mean age (SD) of 42 (9) and 37.5% being post-menopausal, were selected to participate in a cross-sectional study. Areal bone mineral density (aBMD) at the total hip, lumbar spine and non-dominant distal radius was measured by dual-energy X-ray absorptiometry (DXA). Bone geometry, volumetric density and microarchitecture at the non-dominant distal radius were measured by HR-pQCT. Clinical parameters of interest included disease activity, disease damage, major organ involvement (lupus nephritis and neuropsychiatric damage), and use of corticosteroids and cyclophosphomade were recorded.
Disease damage measured by the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SDI) was the only variable constantly associated with bone loss in patients with SLE. Other clinical parameters had minimal effect on bone quality. The median SDI score of the cohort was 0 (interquartile range: 01, range 04), among which 51 (42.5%) had a SDI score >= 1. Ocular (12.5%), neuropsychiatric (10%) and cardiovascular damage (5%) were the most common damages. Forty-two (35%) patients were osteopenic or osteoporotic at total hip, 43 (36%) at lumbar spine, 25 (21%) at radius and 60 (50%) at either 1 site. Strong correlations were found between aBMD and all volumetric/architecture parameters. More organ damage were significantly correlated with more deterioration in trabecular bone quality, including trabecular bone density, trabecular bone volume fraction, trabecular thickness, trabecular separation and standard deviation of 1/trabecular number. After adjusting for age, body mass index, menopausal status and trabecular area, significant correlations still remained between higher SDI score and all the above trabecular bone parameters.
Disease damage has deleterious effect on trabecular bone microarchitecture in female SLE patients on chronic corticosteroids. Preventing disease damage may be effective in preserving bone quality, especially trabecular bone quality in SLE.
To cite this abstract, please use the following information:
Tang, Xiao Lin, Zhu, Tracy Y., Tam, Lai Shan, Li, Edmund K.; Disease Damage Has Deleterious Effect on Trabecualr Bone Microarchitecture in Female Patients with Systemic Lupus Erythematosus On Chronic Corticosteroids. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :974