, Volume 17, Issue 4, pp 271-276

Urinary excretion of the pyridinium cross-links of collagen in systemic lupus erythematosus

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Abstract

The aim of this study was to measure the urinary excretion of the pyridinium cross-links of collagen and to determine their usefulness as markers of reduced bone mineral density in systemic lupus erytgematosus (SLE). All female SLE patients managed at a single centre were invited to participate in a cross-sectional study of urinary pyridinium cross-links excretion (HPLC), bone mineral density (DXA), and SLE-related variables. Ninety-one women with SLE were studied, 35 of whom were postmenopausal. Pyridinoline/Creatinine (Pyd/Cr) and deoxypyridinoline/Cr (Dpd/Cr) levels in postmenopausal women were significantly increased compared with premenopausal values (p=0.010 andp=0.004, respectively). Univariate linear regression analysis revealed a significant association of Dpd/Cr with reduced femoral neck and lumbar spine BMD (p=0.001,p<0.001), and of Pyd/Cr with reduced femoral neck BMD (p=0.020). In addition, the association of Pyd/Cr with reduced lumbar spine BMD approached significance (p=0.055). Stepwise multiple linear regression analysis adjusting for other variables confirmed a significant association of Dpd/Cr with reduced lumbar spine BMD (p=0.006), and a significant association of both Pyd/Cr and Dpd/Cr with postmenopausal status (p=0.003,p<0.001). It was concluded that in this SLE population, the urinary excretion of Dpd/Cr was a useful marker of reduced BMD at the lumbar spine. Menopausal status was a major predictor of cross-links excretion in SLE.