AB0802 THE CORRELATION BETWEEN N-MID OSTEOCALCIN SERUM VALUES AND BONE MINERAL DENSITY VALUES IN FEMALE SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WHO RECEIVED ORAL METHYLPREDNISOLONE THERAPY BASED ON CUMULATIVE DOSES
Authors: S. Hidayatulloh, Z. A. Adnan, A. Nurudhin, Y. Werdiningsih, N. A. Prabowo
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease and involves many organ systems in the body. Glucocorticoids are potent anti-inflammatory and immunosuppressive agents used in patients with SLE. The cumulative dose of steroids is a major risk factor for bone loss. A sensitive indicator that reflects bone remodeling activity is a bone turnover marker (BTM), one of which is N-MID Osteocalcin. Bone Mineral Density (BMD) with DXA can be used to assess osteoporosis. DXA is thus not feasible for screening because of its high cost and lack of machine availability. N-MID Osteocalcin is cheaper and more accessible than DXA. The majority of SLE patients at Moewardi Hospital, Surakarta, received the main therapy for methylprednisolone. Objectives: This study aims to prove the correlation between serum N-MID Osteocalcin values and BMD values in female SLE patients who received oral methylprednisolone therapy based on cumulative doses. Methods: This is a cross-sectional study with random sampling techniques at Rheumatology Clinic Moewardi Hospital, Surakarta. The 38 samples that met the inclusion criteria were measured BMD by DXA and examined for N-MID Osteocalcin by using the Elecsys N-Mid Osteocalcin Kit with the ECLIA method. The cumulative dose of methylprednisolone is calculated in grams. Data analysis used the Shapiro Wilk test, 2 mean difference test (t-test and Mann Whitney test), Chi-Square test, bivariate correlation analysis and, Moderated Regression Analysis. Results: There were 38 samples, 34 (89.47%) normal BMD and, 4 (10.53%) Osteoporosis. The N-MID Osteocalcin has a positive and significant correlation both with the BMD Total L1-L4 as well as the BMD NLF (p &lt;0.05). The cumulative dose of MP has a negative and significant correlation both with the BMD Total L1-L4 also with the BMD NLF (p &lt;0.05). MP cumulative dose can significantly function as a moderation of the effect of N-MID Osteocalcin both on the BMD Total L1-L4 or the BMD NLF. The effect of the N-MID Osteocalcin on the total BMD of L1-L4 or the BMD NLF at the Cumulative Dose MP ≥ 8 g was weaker than that of the MP Cumulative Dose &lt;8 g, and the moderating effect of the correlation between N-MID Osteocalcin and BMD was larger on the total BMD of L1-L4. Conclusion: There is a positive correlation between serum N-MID Osteocalcin values and BMD values in SLE female patients receiving oral methylprednisolone therapy and the cumulative dose of Methylprednisolone affects the correlation between N-MID Osteocalcin values and BMD values in SLE female patients receiving oral methylprednisolone therapy. References: [1]Suarjana I N. 2014. Imunopatogenesis Lupus Eritematosus Sistemik, Dalam: Setiati, S, Alwi, I, Sudoyo, AW, Simadibrata, M, Setiyohadi, B &amp; Syam, AF (editor). Buku Ajar Ilmu Penyakit Dalam vol 6. BP FKUI. Jakarta. [2]Ruiz-Irastorza G, Danza A &amp; Khamashta M. 2012. Glucocorticoid use and abuse in SLE. Rheumatology, 51, 1145-1153. [3]Arslan S, Çeliker R &amp; Karabudak R. 2010. Cumulative Corticosteroid Doses and Osteoporosis in Patients with Muliple Sclerosis. Turk J Rheumatol, 25,191-5. [4]PEROSI. 2010. Panduan diagnosis dan penatalaksanaan osteoporosis. Pengurus Besar Perhimpunan Osteoporosis Indonesia. [5]Kalaiselvi VS, Prabhu K, Ramesh M, Venkatesan VS. 2013. The Association of Serum Osteocalcin with the Bone Mineral Density in Post Menopausal Women. Journal of Clinical and Diagnostic Research, Vol-7(5), 814-816. [6]Ghazi M, Mounach A, Nouijai A, Ghozlani I, Bennani L, Achemlal L, Bezza A, El Maghraoui A. 2007. Performance of the osteoporosis risk assessment tool in Moroccan men. Clin Rheumatol, 26(12), 2037-41 Disclosure of Interests: None declared