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AB0651 Influence of corticosteroid therapy and vitamin D deficiency on bone mineral density in postmenopausal women with systemic lupus erythematosus
  1. D. Marcetic,
  2. R. Stojanovic,
  3. R. Petrovic
  1. Institute of Rheumatology, Belgrade, Serbia

Abstract

Background Postmenopausal women with systemic lupus erythematosus (SLE) are in the risk of vitamin D deficiency (VDD) and osteoporosis. Extensive corticosteroid therapy is also very important factor for bone mineral loss.

Objectives To determine the prevalence of osteoporosis and VDD in postmenopausal women with SLE and its relationship with corticosteroid therapy.

Methods BMD on lumbar spine and/or hip (DEXA) and serum 25(OH)D in 33 postmenopausal women with SLE has been tested. Patients were consecutively visited the Institute of Rheumatology, Belgrade, during fall/winter season. Patients data (age, gender, menopausal status, disease duration, corticosteroid treatment) were collected. Examinees were not used vitamin D supplements. Statistical analysis was performed using SPSS 16.0.

Results The study included 33 postmenopausal females with SLE, mean age 50.55±10.32 years, average disease duration 9.5±6.3 years. There were only 4 (12.1%) women with normal BMD, 21 (63.6%) with osteopenia and 8 (24.2%) with osteoporosis. There were no statistical differences in disease duration between these groups (p>0,05, N.S.). However, estimated cumulative prednisone dose was 13.05 vs. 22.54 vs. 35.35 grams in females with normal BMD vs. osteopenia vs. osteoporosis, resulting in statistically significant diferences in corticosteroid cumulative dose between ostoporosis and osteopenia (p=0.033) and osteoporosis and normal BMD (p=0.044). Mean value of vitamin D has been 14.02ng/ml in females with normal BMD, 13.42ng/ml in females with osteopenia, and 18.59 ng/ml in women with osteoporosis (p>0,05, N.S.). Prevalence of VDD was high - serious vitamin D deficiency (<10 ng/ml) has been found in 12 (36.4%), vitamin D insufficiency (10-30 ng/ml) in 19 (57.6%), and normal 25(OH)D values in only 2 (6.1%) women.

Conclusions Bone mineral loss and vitamin D deficiency are very common in SLE. There were no relationship of serum 25(OH)D level and disease duration with bone mineral density. However, extensive corticosteroid therapy was associated with osteoporosis. Considering high prevalence of osteoporosis and VDD in these group of patients, supplementation with vitamin D should be recommended to all postmenopausal women.

Disclosure of Interest None Declared

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