Ten-year Absolute Fracture Risk and Hip Bone Strength in Canadian Women with Systemic Lupus Erythematosus
| Autor: | Sara Hewitt, Angela M. Cheung, Janet E. Pope, Jennifer J. Y. Lee, Carolyn Neville, Christian A. Pineau, Paul R. Fortin, Valentina Peeva, Deborah DaCosta, Elaheh Aghdassi, Stacey Morrison, Anne Cymet |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Risk Fracture risk Canada medicine.medical_specialty FRAX medicine.drug_class Immunology Osteoporosis Fractures Bone Absorptiometry Photon Rheumatology Adrenal Cortex Hormones Bone Density Internal medicine Prevalence medicine Humans Lupus Erythematosus Systemic Immunology and Allergy Femoral neck Bone mineral Hip Lupus erythematosus Bone Density Conservation Agents Hip Fractures business.industry Middle Aged medicine.disease Surgery medicine.anatomical_structure Hip bone Corticosteroid Female business |
| Zdroj: | The Journal of Rheumatology. 39:1378-1384 |
| ISSN: | 1499-2752 0315-162X |
| Popis: | Objective.Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure.Methods.Women without prior OP fractures were eligible. Bone mineral densities at the hip, spine, and femoral neck were determined using dual-energy x-ray absorptiometry. OP was determined using World Health Organization definitions for participants aged ≥ 50 years (32.8%), and LBM was defined as Z-scores ≤ −2.0 for those aged < 50 years. For those aged ≥ 40 years (63.5%), the 10-year probabilities of a major fracture (FRAX-Major) and hip fracture (FRAX-Hip) were calculated. FRAX-Major ≥ 20% or Hip ≥ 3% was considered high risk. HSA was done in a subgroup (n = 81) of patients.Results.The study group was 271 women. Mean (SD) age was 43.8 (13.1) years and SLE duration was 11.6 (10.4) years. OP was diagnosed in 14.6% and LBM in 8.8%. FRAX-Major ≥ 20% was seen in 9 patients (5.3%), of whom 6 were taking OP medications. FRAX-Hip ≥ 3% occurred in 16 patients (9.4%), of whom 9 were taking OP medications. Buckling ratio at the left hip narrow neck was positively correlated with FRAX-Major, FRAX-Hip, SLE duration, and duration of corticosteroid use.Conclusion.LBM is prevalent in women with SLE who are < 50 years of age. FRAX may identify those at higher risk of fractures while HSA can assess bone structure noninvasively. |
| Databáze: | OpenAIRE |
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