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A Retrospective Analysis of Longitudinal Changes in Bone Mineral Density in Women with Systemic Lupus Erythematosus

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Abstract

Most prospective studies of bone mineral density (BMD) in systemic lupus erythematosus (SLE) patients have been of relatively short duration, with a maximum of 6 years. To describe long-term changes in BMD in women with SLE and identify risk factors associated with BMD loss. We retrospectively evaluated 132 adult Mexican-Mestizo women with SLE who underwent dual X-ray absorptiometry (DXA). Demographic and clinical data were collected and BMD at the lumbar spine (L1–L4) and total hip were collected at baseline and during the follow up. At baseline, the mean age of participants was 43.4 ± 12.5 years, 50.8% had osteopenia and 11% osteoporosis. The median follow-up was 13 (IQR 10.2–14.0) years. During follow up, 79% of patients used glucocorticoid (GCT). The mean percentage of changes in BMD during follow up were: − 14.03 ± 11.25% (− 1.49%/year) at the lumbar spine, and − 15.77 ± 11.57% (− 1.78%/year) at the total hip, with significant changes (p < 0.001 for both comparisons). Multivariate analysis showed older age, GCT use at baseline, and transition to the menopause during the follow-up were significantly associated with greater reductions in BMD. This retrospective longitudinal study found significant BMD loss at the lumbar spine and hip. Older age, menopausal transition and GCT use were independently associated with BMD decline in women with SLE.

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Acknowledgements

The authors thank all patients who participated in the study, which was, in part, supported by a grant from CONCYTEP (Consejo de Ciencia y Tecnologia del Estado de Puebla).

Funding

This study was partly supported by grant from FIS/IMSS/PROT 2018-2106-47. This funding source had no role in the design and conduct of the study, the collection, analysis, and interpretation of the data, or the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Systemic Autoimmune Diseases Research Unit-CIBIOR, Specialities Hospital, CMN., Mexican Social Security Institute, Puebla, Mexico

    Claudia Mendoza-Pinto, Mario García-Carrasco, Daniela Juárez-Melchor & Pamela Munguía-Realpozo

  2. Rheumatology and Immunology Department, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico

    Claudia Mendoza-Pinto, Mario García-Carrasco, Pamela Munguía-Realpozo, Ivet Etchegaray-Morales & Nicolás Santiago-Martín

  3. Postgraduate Unit, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico

    Daniela Juárez-Melchor

  4. Research in Health Coordination, Mexican Social Security Institute, Puebla, Puebla, Mexico

    Jorge Ayón-Aguilar & Socorro Méndez-Martínez

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  1. Claudia Mendoza-Pinto
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  2. Mario García-Carrasco
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Contributions

CMP, MGC, DJM and PMR contributed to the conception and design of the study and wrote and revised the manuscript. DJM, PMR and MNS, IEM contributed to data collection and analysis. CMP and DMJ made the statistical analysis. IEM, JAA and SMM revised the manuscript. All authors contributed to the critical revision and approved the final version for publication.

Corresponding author

Correspondence to Mario García-Carrasco.

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Conflict of interest

The authors report no conflict of interest with respect to the content of the manuscript. Outside the submitted work, Dr García-Carrasco reports royalty payments from UCB for the publication of books/chapters. The remaining authors have no conflict of interests.

Human and Animal Rights and Informed Consent

The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Local Ethics Committee, IMSS (R-2018-2106-035).

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Mendoza-Pinto, C., García-Carrasco, M., Juárez-Melchor, D. et al. A Retrospective Analysis of Longitudinal Changes in Bone Mineral Density in Women with Systemic Lupus Erythematosus. Calcif Tissue Int 109, 363–371 (2021). https://doi.org/10.1007/s00223-021-00845-0

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