Bone mineral density in premenopausal women with rheumatoid arthritis and systemic lupus erythematosus

ABSTRACT

Little is known about bone mineral density [BMD], as measured by dual energy x-ray absorptiometry [DEXA], in patients with rheumatoid arthritis [RA] versus matched systemic lupus erythematosus [SLE] and healthy controls at the same time. However, most of these data have been confined to Caucasian population with conflicting results. Also factors controlling bone homeostasis may be different between ethnic groups with lacking data in Orientals. Is to study BMD in premenopausal women with RA and to compare the data of RA patients with matched SLE patients and healthy controls. Moreover, is to evaluate the possible relationship between BMD and disease variables. This study included 60 premenopausal women divided into three equal groups, 20 subjects each, RA patients group, SLE patients group, and healthy controls group. BMD at the lumbar spine [L1-L4] was measured by DEXA. Also, disease variables and biochemical parameters were assessed. Patients with RA and SLE had significantly lower BMD values at lumbar spine compared to healthy controls [p=0.0001]. Similar BMD values were detected in RA and SLE patients. Osteopenia was detected in 40% of RA and SLE patients groups, while osteoporosis [OP] was detected in 40% and 30% of those patients, respectively. There was no correlation between BMD and age of patients, body mass index [BMI], disease activity, as well as disease duration. In contrast, there was an inverse correlation between BMD and dose as well as duration of corticosteroid [CS] therapy [p<0.05]. A high incidence of low BMD at the lumbar spine was found in our premenopausal women with RA and SLE on chronic CS and calcium supplementation compared with healthy controls. In those patients, BMD was related to the dose and duration of CS therapy, but not with disease duration or disease activity