Rheumatology 2000; 39: 389-392
© 2000 British Society for Rheumatology
Longitudinal analysis of bone mineral density in pre-menopausal female systemic lupus erythematosus patients: deleterious role of glucocorticoid therapy at the lumbar spine
Rheumatology and
1 General Internal Medicine Departments, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium
Objective. To evaluate whether bone loss occurs over time in pre-menopausal systemic lupus erythematosus (SLE) patients.
Methods. We performed a longitudinal bone mineral density (BMD) analysis in a group of 35 pre-menopausal female SLE patients. Lumbar spine and hip (total and sub-regions) BMDs were measured twice 21 ± 11 (mean ± S.D.) months apart by dual-energy X-ray absorptiometry.
Results. In the whole cohort of SLE patients, significant bone loss was observed at the lumbar spine (-1.22%/yr) but not at the total hip. Further analyses indicated that lumbar spine bone loss (-2.12%/yr) occurred exclusively in the subgroup of patients who had taken a mean prednisolone daily dose >7.5 mg between the two BMD measurements. Moreover, bone loss was more important in patients who had previously received a cumulative prednisolone dose 
5 g by the time of their first BMD evaluation.
Conclusions. These results, by demonstrating a loss of lumbar spine bone over time in pre-menopausal SLE patients given glucocorticoid (GC) therapy, strongly support the use of preventive treatment to minimize GC-induced osteoporosis in pre-menopausal female SLE patients given prednisolone daily doses >7.5 mg.
KEY WORDS: SLE, Osteoporosis, Glucocorticoids, BMD, Longitudinal, Pre-menopausal females.
Correspondence to: F. A. Houssiau.
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