Bone mineral density and biochemical parameters of bone metabolism in female patients with systemic lupus erythematosus
- Kurt Redlicha,
- Sophie Zieglera,
- Hans P Kienera,
- Susanne Spitzauerc,
- Petra Stohlawetza,
- Peter Berneckera,
- Franz Kainbergere,
- Stephan Gramppe,
- Stefan Kudlacekf,
- Wolfgang Woloszczukd,
- Josef S Smolena,
- Peter Pietschmannb
- aDepartment of Internal Medicine 3, Division of Rheumatology, University of Vienna, Austria, bDivision of Rheumatology and Institute of General and Experimental Pathology, cInstitute of Medical Chemistry and Laboratory Diagnostics, dLudwig Boltzmann Institute of Experimental Endocrinology, eDepartment of Radiology, Division of Osteoradiology, Austria, fKrankenhaus der Barmherzigen Brüder, Department of Internal Medicine, Vienna, Austria
- Dr Pietschmann, Department of Internal Medicine 3, Divison of Rheumatology, University of Vienna, Vienna General Hospital, Währinger Gürtel 18–20, A-1090 Vienna, Austria
- Accepted 10 December 1999
OBJECTIVE To evaluate bone mineral density and biochemical parameters of bone metabolism in ambulatory premenopausal female patients with systemic lupus erythematosus (SLE).
METHODS 30 women who fulfilled the ARA criteria for the classification of SLE were studied. Lumbar and femoral bone mineral density was determined by dual energyx ray absorptiometry. Various laboratory parameters including serum calcium, serum phosphorus, alkaline phosphatase, bone specific isoform of alkaline phophatase, propeptide of type 1 procollagen, deoxypyridinoline excretion, telopeptide of type 1 collagen, serum creatinine, osteocalcin, parathyroid hormone, 25-OH vitamin D, testosterone, progesterone, estradiol, follicle stimulating hormone and luteinotropic hormone were measured.
RESULTS According to the WHO criteria 39% of all patients with SLE studied had normal bone mineral density, 46% had osteopenia and 15% had osteoporosis at the lumbar spine; at the femoral neck 38.5% had normal bone mineral density, 38.5% had osteopenia and 23% suffered from osteoporosis. Significantly lower osteocalcin levels were found in SLE patients. All other bone resorption and formation markers measured were not statistically different, but higher serum albumin corrected calcium and lower phosphorus values were found in the SLE group. Of all sex hormones tested lower testosterone and higher follicle stimulating hormone concentrations were seen in patients with SLE.
CONCLUSION A high incidence was found of osteopenia and osteoporosis in premenopausal patients with SLE. Bone diminution in SLE seems to be attributable, at least in part, to decreased bone formation in SLE patients.
Funding: this research was supported by: “Medizinisch-Wissenschaftlicher Fonds des Bürgermeisters der Bundeshauptstadt Wien”.