Evaluation of Bone Mineral Density in Juvenile Systemic Lupus Erythematosus

Document Type : RESEARCH PAPER

Authors

1 1 Children’s Medical Center, Pediatrics Center of Excellence, Tehran, Iran 2 Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran

2 1 Children’s Medical Center, Pediatrics Center of Excellence, Tehran, Iran 2 Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran 3 Pediatric Rheumatology Society of Iran, Tehran, Iran

3 2 Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran 3 Pediatric Rheumatology Society of Iran, Tehran, Iran

4 1 Children’s Medical Center, Pediatrics Center of Excellence, Tehran, Iran 2 Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran 3 Pediatric Rheumatology Society of Iran, Tehran, Iran 4 Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Objectives: The present study aimed to determine the prevalence of low bone mineral density (BMD)
and low bone mineral content (BMC) as chronic complications of juvenile systemic lupus erythematosus
(JSLE) and identify the associated variables and patient characteristics to investigate the relationship
between BMD and influential factors.
Methods: This cross-sectional study enrolled 54 patients with JSLE, including 38 females and 16 males. The BMD
and BMC were assessed by dual-energy X-ray absorptiometry in the hip (femoral neck) and the lumbar spine. Low
BMD was considered a Z-score < -2. The study investigated the association of BMC and Z-score with the current
daily dose of corticosteroids, the daily dose of corticosteroids at disease onset, the duration of disease, the duration
of steroid treatment, the time from the onset of symptoms to diagnosis, and renal involvement.
Results: The prevalence of low BMD in the lumbar spine and the femoral neck was 14.8% and 18.5%, respectively;
the reduction of BMD was more significant in the femoral neck compared to the lumbar spine. Osteoporosis was
detected in one patient. The multiple linear regression analysis found a significant association between a higher
daily corticosteroid dose and lower BMC of the femoral neck and the lumbar spine. In addition, patients receiving
higher doses of corticosteroids at disease onset showed better follow-up bone mineral densitometry results.
Conclusion: Based on the findings of this study, JSLE more affects the femoral neck than the lumbar spine. Patients
receiving a more robust treatment with higher doses of corticosteroids at disease onset (to control the inflammatory
processes) showed better spinal BMC results. A higher dose of daily corticosteroid treatment during assessment
was identified as a risk factor for low BMD.
 Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 11, Issue 12
December 2023
Pages 777-782

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History

  • Receive Date: 26 February 2023
  • Revise Date: 15 October 2023
  • Accept Date: 09 July 2023

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