Cortical thinning and progressive cortical porosity in female patients with systemic lupus erythematosus on long-term glucocorticoids: a 2-year case-control study

详细信息    查看全文

• 作者：T. Y. Zhu ; J. F. Griffith ; L. Qin ; V. W. Y. Hung ; T.-N. Fong…
• 关键词：Bone microstructure ; Glucocorticoids ; HR ; pQCT ; Osteoporosis ; Systemic lupus erythematosus
• 刊名：Osteoporosis International
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：26
• 期：6
• 页码：1759-1771
• 全文大小：1,007 KB
• 参考文献：1.D'Cruz DP, Khamashta MA, Hughes GR (2007) Systemic lupus erythematosus. Lancet 369(9561):587-96PubMed View Article
  2.Mak A, Isenberg DA, Lau CS (2013) Global trends, potential mechanisms and early detection of organ damage in SLE. Nat Rev Rheumatol 9(5):301-10. doi:10.-038/?nrrheum.-012.-08 PubMed View Article
  3.Bultink IE (2012) Osteoporosis and fractures in systemic lupus erythematosus. Arthritis Care Res (Hoboken) 64(1):2-. doi:10.-002/?acr.-0568 View Article
  4.Li EK, Tam LS, Griffith JF, Zhu TY, Li TK, Li M, Wong KC, Chan M, Lam CW, Chu FS, Wong KK, Leung PC, Kwok A (2009) High prevalence of asymptomatic vertebral fractures in Chinese women with systemic lupus erythematosus. J Rheumatol 36(8):1646-652PubMed View Article
  5.Bultink IE, Lems WF, Kostense PJ, Dijkmans BA, Voskuyl AE (2005) Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis Rheum 52(7):2044-050PubMed View Article
  6.Seeman E, Delmas PD (2006) Bone quality—the material and structural basis of bone strength and fragility. N Engl J Med 354(21):2250-261PubMed View Article
  7.Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90(12):6508-515PubMed View Article
  8.Sornay-Rendu E, Boutroy S, Munoz F, Delmas PD (2007) Alterations of cortical and trabecular architecture are associated with fractures in postmenopausal women, partially independent of decreased BMD measured by DXA: the OFELY study. J Bone Miner Res 22(3):425-33PubMed View Article
  9.Seeman E, Delmas PD, Hanley DA, Sellmeyer D, Cheung AM, Shane E, Kearns A, Thomas T, Boyd SK, Boutroy S, Bogado C, Majumdar S, Fan M, Libanati C, Zanchetta J (2010) Microarchitectural deterioration of cortical and trabecular bone: differing effects of denosumab and alendronate. J Bone Miner Res 25(8):1886-894PubMed Central PubMed View Article
  10.Burghardt AJ, Kazakia GJ, Sode M, de Papp AE, Link TM, Majumdar S (2010) A longitudinal HR-pQCT study of alendronate treatment in postmenopausal women with low bone density: relations among density, cortical and trabecular microarchitecture, biomechanics, and bone turnover. J Bone Miner Res 25(12):2558-571PubMed Central PubMed View Article
  11.Tang XL, Qin L, Kwok AW, Zhu TY, Kun EW, Hung VW, Griffith JF, Leung PC, Li EK, Tam LS (2013) Alterations of bone geometry, density, microarchitecture, and biomechanical properties in systemic lupus erythematosus on long-term glucocorticoid: a case-control study using HR-pQCT. Osteoporos Int 24(6):1817-826. doi:10.-007/?s00198-012-2177-5 PubMed View Article
  12.Tang XL, Zhu TY, Hung VW, Qin L, Wong CK, Kun EW, Tam LS, Li EK (2012) Increased organ damage associated with deterioration in volumetric bone density and bone microarchitecture in patients with systemic lupus erythematosus on longterm glucocorticoid therapy. J Rheumatol 39(10):1955-963. doi:10.-899/?jrheum.-20213 PubMed View Article
  13.Tang XL, Griffith JF, Qin L, Hung VW, Kwok AW, Zhu TY, Kun EW, Leung PC, Li EK, Tam LS (2013) SLE disease per se contributes to deterioration in bone mineral density, microstructure and bone strength. Lupus 22(11):1162-168. doi:10.-177/-961203313498802-/span> PubMed View Article
  14.Jacobs J, Korswagen LA, Schilder AM, van Tuyl LH, Dijkmans BA, Lems WF, Voskuyl AE, Bultink IE (2012) Six-year follow-up study of bone mineral density in patients with systemic lupus erythematosus. Osteoporos Int 24(6):1827-833. doi:10.-007/?s00198-012-2157-9 PubMed View Article
  15.Jardinet D, Lefebvre C, Depresseux G, Lambert M, Devogelaer JP, Houssiau FA (2000) Longitudinal analysis of bone mineral density in pre-menopausal female systemic lupus erythematosus patients: deleterious role of glucocorticoid therapy at the lumbar spine. Rheumatology (Oxford) 39(4):389-92View Article
  16.Boyanov M, Robeva R, Popivanov P (2003) Bone mineral density changes in women with systemic lupus erythematosus. Clin Rheumatol 22(4-):318-23PubMed View Article
  17.Zhu TY, Griffith JF, Au SK, Tang XL, Kwok AW, Leung PC, Li EK, Tam LS (2014) Bone mineral density change in systemic lupus erythematosus: a 5-year followup study. J Rheumatol 41(10):1990-997. doi:10.-899/?jrheum.-31190 PubMed View Article
  18.Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725PubMed View Article
  19.Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis Rheum 35(6):630-40PubMed View Article
  20.Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, Bacon P, Bombardieri S, Hanly J, Hay E, Isenberg D, Jones J, Kalunian K, Maddis
• 作者单位：T. Y. Zhu (1) (2)
  J. F. Griffith (3)
  L. Qin (2)
  V. W. Y. Hung (2)
  T.-N. Fong (2)
  S.-K. Au (4)
  X.-L. Tang (1)
  E. W. Kun (5)
  A. W. Kwok (4)
  P.-C. Leung (4)
  E. K. LI (1)
  L.-S. Tam (1) (6)
  
  1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
  2. Bone Quality and Health Center, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
  3. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
  4. The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
  5. Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, Hong Kong SAR, China
  6. Department of Medicine & Therapeutics, The Prince of Wales Hospital, 9/F Clinical Sciences Building, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong SAR, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  Gynecology
  Endocrinology
  Rheumatology
  
• 出版者：Springer London
• ISSN：1433-2965

文摘

Summary In this study, we characterized longitudinal changes of volumetric bone mineral density and cortical and trabecular microstructure at the distal radius using HR-pQCT in female systemic lupus erythematosus (SLE) patients on long-term glucocorticoids. Cortical thinning and increased cortical porosity are the major features of longitudinal microstructural deterioration in SLE patients. Introduction The study aims to characterize longitudinal changes of volumetric bone mineral density (vBMD) and bone microstructure at distal radius in female systemic lupus erythematosus (SLE) patients on long-term glucocorticoids. Methods This 2-year case-control study consisted of 166 premenopausal subjects (75 SLE patients and 91 controls) and 79 postmenopausal subjects (44 SLE patients and 35 controls). We obtained areal BMD (aBMD) by dual-energy X-ray absorptiometry at multiple skeletal sites and indices of vBMD and microstructure at distal radius by high-resolution peripheral quantitative computed tomography (HR-pQCT) at baseline, 12 and 24?months. Results In either premenopausal or postmenopausal subjects, changes in aBMD did not differ between patients and controls except that decrease in aBMD at total hip at 24?months in premenopausal patients was significantly higher. In premenopausal subjects, decrease in cortical area (?.51 vs. ?.06?%, p--.039) and thickness (?.63 vs. 0.02?%, p--.031) and increase in cortical porosity (21.7 vs. 7.16?%, p--.030) over study period were significantly larger in patients after adjustment of age and body mass index. Decreased in trabecular vBMD was significantly less (?.63 vs. ?.32?%, p--.001) with trabecular microstructure better maintained in patients. In postmenopausal subjects, decrease in cortical vBMD (?.66 vs. ?.56?%, p--.039) and increase in cortical porosity (41.6 vs. 16.3?%, p--.021) were significantly higher in patients, and there was no group-wise difference in change of trabecular microstructure. Conclusion Longitudinal microstructural deterioration in SLE is characterized by cortical thinning and increased cortical porosity. Cortical bone is an important source of bone loss in SLE patients on glucocorticoids.