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MR Vol.12 No.4 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.4 |
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Reduced bone mineral density in Japanese premenopausal
women with systemic lupus erythematosus treated with glucocorticoids |
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| S. Banno1, Y. Matsumoto1, T. Naniwa1, Y.
Hayami 1, Y. Sugiura1, T. Yoshinouchi1, R. Ueda1 |
| (1)Second Department of Internal Medicine,
Medical School, Nagoya City University, 1 Kawasumi, Mizuho-ku,
Nagoya 467-8601, Japan |
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| Abstract |
| Abstract We evaluated bone mineral density
(BMD) in Japanese female patients with systemic lupus erythematosus
(SLE) and assessed the influence of the use of glucocorticoids.
Lumbar BMD was measured by dual x-ray absorptiometry (DXA) in 60
premenopausal females who previously had been receiving glucocorticoid
therapy. Therapeutic- and disease-related variables for SLE were
analyzed and bone resorption or formation markers were measured.
Osteoporosis was defined as a T-score below 2.5 SD by DXA; 12 patients
(20%) showed osteoporosis, and 30 (50%) had osteopenia. Compared
with the nonosteoporotic group (n = 48), the osteoporotic group
(n = 12) had a significantly longer duration of glucocorticoid
treatment (P = 0.01), a cumulative prednisolone dose (P = 0.002),
and an SLE damage index (SLICC/ACR). There was no difference in
the incidence of osteoporosis either with or without the previous
use of methyl-prednisolone pulse or immunosuppressive drugs. There
was a significant positive correlation between urinary type I collagen
cross-linked N-telopeptides (NTx) and serum bone-specific alkaline
phosphatase (BAP) (r = 0.404, P = 0.002), but these bone metabolic
markers showed no difference between the osteoporotic and nonosteoporotic
groups. A good significant negative correlation was shown between
BMD and the cumulative glucocorticoid dose (r = m0.351, P = 0.007).
Stepwise logistic regression analysis showed that the cumulative
glucocorticoid intake was independently associated with osteoporosis.
Glucocorticoid-induced osteoporosis was frequently observed in
Japanese SLE patients, as in Caucasian populations. The cumulative
glucocorticoid dose was associated with an increased risk for osteoporosis.
Bone metabolic markers such as NTx and BAP were not influenced
by glucocorticoid treatment and could not predict current osteoporosis
in SLE patients. |
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| Key words |
| Key words Bone metabolic marker ・ Bone-specific
alkaline phosphatase (BAP) ・ Glucocorticoid-induced osteoporosis
・ Systemic lupus erythematosus
(SLE) ・ Type I collagen cross-linked N-telopeptides (NTx) |
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