Four Years Follow-up of Bone Mineral Density Change in Premenopausal Women with Systemic Lupus Erythematosus
Somchai Uaratanawong MD*, Utis Deesomchok MD**, Narin Hiransuttikul MD, PhD***, Somsri Uaratanawong BSc****
Affiliation : * Department of Medicine, Bangkok Metropolitan Administration and Vajira Hospital ** Department of Medicine, Faculty of Medicine, Chulalongkorn University *** Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University **** Department of Radiology, Bangkok Metropolitan Administration and Vajira Hospital
Objective : To measure the change in bone mineral density (BMD) in premenopausal women with systemic
lupus erythematosus (SLE) during 4 years of follow-up, and to identify the role of glucocorticoid and disease
related variables.
Method : Premenopausal women with SLE were clinically evaluated and underwent BMD measurement of
the lumbar spine, femoral neck and trochanter by dual energy x-ray absorptiometry.
Results : 106 SLE patients were evaluated with a mean age of 31.7 + 7.5 years, duration of SLE 2.5 + 2.6
years, mean daily dose 17.1 + 14 mg/d, duration of prednisolone treatment 16.3 + 19.9 months during 4
years of follow-up. There was no significant change in BMD at the lumbar spine (1.051 + 0.15 vs 1.052 + 0.14
vs 1.056 + 0.17 vs 1.056 + 0.19; p = 0.27), femoral neck (0.861 + 0.12 vs 0.867 + 0.12 vs 0.846 + 0.12 vs
0.844 + 0.12; p = 0.28) and trochanter (0.718 + 0.12 vs 0.726 + 0.13 vs 0.717 + 0.13 vs 0.709 + 0.14; p =
0.26) at the baseline, first, second and fourth year follow-up study. Furthermore, annual percentage BMD
changes were not significant in lumbar BMD (p = 0.37), femoral neck BMD (p = 0.65) and trochanteric BMD
(p = 0.47) during the 4 years follow-up study. The average annual percentage change of BMD was not
significantly associated with change in age, body mass index (BMI), disease activity, disease severity, disease
duration and prednisolone treatment. In addition, there were no significant bone changes between subgroups
treated with < 7.5 mg and > 7.5 mg daily dose of prednisolone as indicated by BMD at the lumbar spine,
femoral neck and trochanter as well as annual percentage BMD changes over the study period.
Conclusion : There was no significant change of lumbar spine, femoral neck or trochanteric BMD in pre-
menopausal SLE women treated with corticosteroid. These findings suggest that low dose prednisolone may
not be detrimental to bone in premenopausal women with SLE during longterm treatment.
Keywords : Bone mineral density, Systemic lupus erythematosus, Glucocorticoids
