A Study to Observe the Alternations of Bone Mass in Women with Systemic Lupus Erythematosus after Long-term Treatment with Glucocorticoids
|Keywords||Systemic lupus erythematosus Bone mineral density Glucocorticoid Osteoporosis|
Objective A study to observe the alternations of bone mass in women with systemic lupus erythematosus (Systemic Lupus Erythematosus, SLE) after long-term treatment with glucocorticoids so that intervening the occurence of osteoporosis timely. Methods 20 Patients with SLE were treated and followed up for 1 year. The initial dose of glucocorticoids(prednisone) was 1mg (kg.d). The daily dose was diminished gradually after 6-8 weeks on the basis of 5mg per 2 weeks until the maintenance dose(below 10mg). Proximal femur and lumbar spine dual-energy X-ray absorptiometry results were evaluated in SLE patients before taking glucocorticoids and after oral glucocorticoids treatment for 3 months,6 months and 12months,and 20 age-matched healthy women were compared with SLE patients. The data between two groups were compared with paired t test. The data in SLE group were compared with self-comparison t test. There were statistical difference when P<0.05. Results BMD of lumar spine and proximal femur were lower in SLE patients after oral glucocorticoids treatment than matched normal controls(P<0.01).Lu mbar spine BMD (1.112±0.131 vsl.225±0.134,t=2.62,P<0.01), proximal femur BMD (0.816±0.125vs0.915±0.128,t=2.58,P<0.01). lumbar spine in SLE patients after taking glucocorticoids for 6 months were less than 3 months. BMD (1.001±0.132vs1.112±0.131,1=2.65, P<0.01).There were no difference in BMD of Lumbar spine after taking glucocorticoids for 6 months and 12 months. BMD (1.001±0.132vs1.112±0.131, t=2.65, P<0.01).There were no difference in BMD of proximal femur in SLE patients with oral glucocorticoids for 3 months and 6 months and 12 months, proximal femur BMD (0.816±0.125vs0.810±0.123vs0.806±0.123, t≤1.56, P>0.05). The occurrence rate of osteopenia were 10%,25%,30% after taking glucocorticoids for 3 months,6 months and 12 months at the lumbar spine, and the occurrence rate of osteopenia were all 10% at the proximal femur. The occurrence rate of osteoporosis were all 10% at the proximal femur and the lumbar spine 12 months later. Conclusion BMD in SLE patients treated with long-term glucocorticoids was significantly less than normal controls. The speed of bone loss was also different because of different part in human body. The influence of glucocorticoids on bone mass was different based on different part in human body.