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Study of bone mineral density and serum bone turnover markers in newly diagnosed systemic lupus erythematosus patients
Received date: 2018-08-27
Online published: 2018-12-18
Supported by
Supported by the National Natural Science Foundation of China(81801618)
Objective: To investigate the changes of bone mineral density (BMD) and serum bone turnover factor in newly diagnosed systemic lupus erythematous (SLE) patients.Methods:Eighty newly diagnosed SLE patients and 80 age and gender matched healthy controls were enrolled. None of the SLE patients had ever received glucocorticoid,immunosuppressive agents or vitamin D. BMD was measured at radius,lumbar spine and hip by dual X ray absorptiometry (DXA). Bone turnover markers including se-rum levels of tartrate-resistant acid phosphatase 5b (TRAP5b),bone alkaline phosphatase (BAP) and 25-hydroxy vitamin D3 (25-OH-VD3) were measured by enzyme-linked immunosorbent assay (ELISA). Logistic regression was employed to analyze the risk factors associated with decreased BMD.Results:Mean age of the SLE patients was (32.8±12.4) years,and 85% were female,none of whom were post-menopausal. BMD was significantly reduced in all the measured sites,compared with the healthy controls. Sixteen (20%) of the patients were osteopenic in at least one site measured locations. The serum levels of 25-OH-VD3 were markedly reduced in the newly diagnosed SLE patients than those of the normal controls [(46.1+12.3) nmol/L vs. (25.4+11.2) nmol/L,P<0.001)]. The serum levels of 25-OH-VD3 in the SLE patients with nephritis were much lower than those without nephritis (P=0.04). A significant negative correlation was demonstrated between the serum concentration of 25-OH-VD3 and the disease activity scores as measured by SLE disease activity index (SLEDAI) (r=-0.3,P=0.001). The serum TRAP5b concentration was positively correlated with SLEDAI (r=0.435,P=0.003). Age (P=0.058) and SLEDAI (P=0.085) were probably associated with decreased BMD in Logistic regression analysis.Conclusion:The study showed reduced BMD in untreated SLE patients. The role of chro-nic inflammation was of probable importance in bone metabolism.
Hai-hong YAO , Su-mei TANG , Zhi-min WANG , Xia ZHANG , Xu-yong CHEN , Li GAO , Jing LIU , Yi-jun DAI , Zhao-heng HU , Xue-wu ZHANG , Zhan-guo LI . Study of bone mineral density and serum bone turnover markers in newly diagnosed systemic lupus erythematosus patients[J]. Journal of Peking University(Health Sciences), 2018 , 50(6) : 998 -1003 . DOI: 10.19723/j.issn.1671-167X.2018.06.010
| [1] | Hochberg MC . Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum, 1997,40(9):1725. |
| [2] | Guo Q, Fan P, Luo J , et al. Assessment of bone mineral density and bone metabolism in young male adults recently diagnosed with systemic lupus erythematosus in China[J]. Lupus, 2017,26(3):289-293. |
| [3] | Boyanov M, Robeva R, Popivanov P . Bone mineral density changes in women with systemic lupus erythematosus[J]. Clin Rheumatol, 2003,22(4-5):318-323. |
| [4] | Coimbra IB, Costallat LT . Bone mineral density in systemic lupus erythematosus and its relation to age at disease onset, plasmatic estradiol and immunosuppressive therapy[J]. Joint Bone Spine, 2003,70(1):40-45. |
| [5] | Almehed K , Forsblad dH, Kvist G, et al. Prevalence and risk factors of osteoporosis in female SLE patients-extended report[J]. Rheumatology (Oxford), 2007,46(7):1185-1190. |
| [6] | Furukawa M, Kiyohara C, Tsukamoto H , et al. Prevalence of and risk factors for low bone mineral density in Japanese female patients with systemic lupus erythematosus[J]. Rheumatol Int, 2011,31(3):365-376. |
| [7] | Cramarossa G, Urowitz MB, Su J , et al. Prevalence and associa-ted factors of low bone mass in adults with systemic lupus erythematosus[J]. Lupus, 2017,26(4):365-372. |
| [8] | Compeyrot-Lacassagne S, Tyrrell PN, Atenafu E , et al. Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus[J]. Arthritis Rheum, 2007,56(6):1966-1973. |
| [9] | Alsufyani KA, Ortiz-Alvarez O, Cabral DA , et al. Bone mineral density in children and adolescents with systemic lupus erythematosus, juvenile dermatomyositis, and systemic vasculitis: relationship to disease duration, cumulative corticosteroid dose, calcium intake, and exercise[J]. J Rheumatol, 2005,32(4):729-733. |
| [10] | Lilleby V, Lien G, Frey FK , et al. Frequency of osteopenia in children and young adults with childhood-onset systemic lupus erythematosus[J]. Arthritis Rheum, 2005,52(7):2051-2059. |
| [11] | Ure?a P, Hruby M, Ferreira A , et al. Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients[J]. J Am Soc Nephrol, 1996,7(3):506-512. |
| [12] | Shidara K, Inaba M, Okuno S , et al. Serum levels of TRAP5b, a new bone resorption marker unaffected by renal dysfunction, as a useful marker of cortical bone loss in hemodialysis patients[J]. Calcif Tissue Int, 2008,82(4):278-287. |
| [13] | Keronen S, Martola L, Finne P , et al. Bone histomorphometry and indicators of bone and mineral metabolism in wait-listed dialysis patients[J]. Clin Nephrol, 2016,85(3):127-134. |
| [14] | Dhillon VB, Davies MC, Hall ML , et al. Assessment of the effect of oral corticosteroids on bone mineral density in systemic lupus erythematosus: a preliminary study with dual energy X ray absorptiometry[J]. Ann Rheum Dis, 1990,49(8):624-626. |
| [15] | Breslin LC, Magee PJ, Wallace JM , et al. An evaluation of vitamin D status in individuals with systemic lupus erythematosus[J]. Proc Nutr Soc, 2011,70(4):399-407. |
| [16] | Bartels LE, Hvas CL, Agnholt J , et al. Human dendritic cell antigen presentation and chemotaxis are inhibited by intrinsic 25-hydroxy vitamin D activation[J]. Int Immunopharmacol, 2010,10(8):922-928. |
| [17] | Jirapongsananuruk O, Melamed I, Leung DY . Additive immunosuppressive effects of 1, 25-dihydroxy vitamin D3 and corticosteroids on TH1, but not TH2, responses[J]. J Allergy Clin Immunol, 2000,106(5):981-985. |
| [18] | Correale J, Ysrraelit MC, Gaitán MI . Immunomodulatory effects of vitamin D in multiple sclerosis[J]. Brain, 2009,132(Pt 5):1146-1160. |
| [19] | Ruiz-Irastorza G, Gordo S, Olivares N , et al. Changes in vitamin D levels in patients with systemic lupus erythematosus: Effects on fatigue, disease activity, and damage[J]. Arthritis Care Res (Hoboken), 2010,62(8):1160-1165. |
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