AB0315 DISEASE DAMAGE ACCRUAL AND LOW BONE MINERAL DENSITY IN FEMALE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: M. Correa Rodríguez, G. Pocovi-Gerardino, J. L. Callejas-Rubio, R. Ríos Fernández, S. Delolmo-Romero, N. Ortego, B. Rueda-Medina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Osteoporosis is a common comorbidity in patients with systemic lupus erythematosus (SLE). Available evidence showed that autoimmunity and associated inflammation play main effect in the pathogenesis of negative skeletal effects in SLE patients. However, the potential contribution of disease-associated factors to bone status in SLE is not well known since the reported risk factors from different studies differ greatly. Objectives: The aim of this study was to examine frequency of reduced bone mass in SLE women, and determine their potential associations with disease activity, damage accrual and SLE-related clinical markers. Methods: A cross-sectional study including a total 121 Caucasian pre-menopausal and postmenopausal women was conducted (mean age 49.29±12.43 years). The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Bone mineral density (BMD) of the left femoral neck and lumbar spine (L2–L4) were measured by dual-energy X-ray absorptiometry (Hologic QDR 400). Results: Ten patients (8.3%) had osteoporosis, 63 (52.1%) patients had osteopenia and 6.8% of women had history of previous fracture. Patients with low bone mass had a significantly higher mean SDI (1.36±1.26 versus 0.70±1.09 p=0.003). T-score at lumbar spine was inversely correlated with SDI score (r=-0.222, p=0.014) and complement C3 level (r=-0.206, p=0.024). Results of bivariate correlations showed that T-score at lumbar spine was inversely correlated with SDI score (r=-0.222, p=0.014) and complement C3 level (r=-0.206, p=0.024). SDI scores were significantly different between patients with osteoporosis, osteopenia and normal BMD after adjusting for age, menstrual status, BMI, time since diagnosis and corticoid use (p=0.004). Conclusion: There is a high prevalence of low BMD in Caucasian women with SLE and this status of osteopenia/osteoporosis was associated with higher damage accrual scores, supporting that disease damage may itself be a major contributor to the low BMD. SLE women with organ damage require regular bone status monitoring to prevent further musculoskeletal damage. Since diminished BMD is a main comorbidity it is therefore essential to study, monitor and prevent osteoporosis in SLE women to avoid fractures leading to reduced quality of life. References: [1]Wang X, Yan S, Liu C, Xu Y, Wan L, Wang Y, et al. Fracture risk and bone mineral density levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Osteoporos Int 2016;27:1413–23. [2]Mendoza-Pinto C, Rojas-Villarraga A, Molano-Gonzalez N, Jimenez-Herrera EA, De La Luz Leon-Vazquez M, Montiel-Jarquõn A, et al. Bone mineral density and vertebral fractures in patients with systemic lupus erythematosus: A systematic review and meta-regression. PLoS One 2018;13:1–15. [3]Xia J, Luo R, Guo S, Yang Y, Ge S, Xu G, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. Biomed Res Int 2019;2019. [4]Carli L, Tani C, Spera V, Vagelli R, Vagnani S, Mazzantini M, et al. Risk factors for osteoporosis and fragility fractures in patients with systemic lupus erythematosus. Lupus Sci Med 2016;3:1–5. Acknowledgements: This research was supported by the grant PI0523-2016 from “Consejería de igualdad, salud y políticas sociales” (Junta de Andalucía) and is part of the research group LyDIMED “Lupus y Dieta Mediterránea”. Disclosure of Interests: None declared