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Incidence of Vertebral Fractures in Women with Systemic Lupus Erythematosus After 8 Years of Follow-Up

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Abstract

The aim of this study was to evaluate possible associations between potential risk factors and the occurrence of established vertebral fractures (VF) in Mexican patients with systemic lupus erythematosus (SLE). Consecutive patients with SLE were enrolled in a prospective, observational study from 2006 to 2015. Information on potential risk factors, including demographics, clinical data, and bone mineral density (BMD) at the lumbar spine and hip on dual-energy X-ray absorptiometry was collected at baseline and follow-up. Semiquantitative analysis was used to determine incident VF on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20–25% reduction or more in any vertebral height) during follow-up. Differences in baseline characteristics were assessed in patients with and without new radiographic VF. Of 110 SLE patients included, with a median follow-up of 8 (IQR 8–9) years, 22 (20%) had radiographic VF at baseline; 35 (32%) patients had a new VF. The annual incidence rate of new morphometric VF was 3.5 (95% CI 2.4–4.91) per 100 patient/years. Most fractures were mild or moderate and biconcave shaped. Incident VF were significantly associated with baseline BMD at the total hip and longer disease duration. Cumulative glucocorticoid dose, postmenopausal status, and previous prevalent VF were not associated with VF. In this SLE cohort in daily clinical practice, new VF were frequently present in SLE patients, especially those with longer disease duration and low-hip BMD.

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Acknowledgements

The authors would like to thank all patients who participated in this study for their patience and understanding. We would like to thank David Buss for his valuable guidance and advice during this project. This work was in part supported by a grant from “Programa para el Desarrollo Profesional Docente, para el Tipo Superior” (SEP-PRODEP) “Integración de redes temáticas de colaboración académica”.

Funding

This work was supported in part by grant from FIS/IMSS/PROT/MD15/1500. This funding source had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Systemic Autoimmune Diseases Research Unit, Hospital General Regional 36-CIBIOR, Instituto Mexicano del Seguro Social, Av. 10 Poniente 2721, Amor, 72090, Puebla, Puebla, Mexico

    Mario García-Carrasco, Claudia Mendoza-Pinto, María de la Luz León-Vázquez, Ivet Etchegaray-Morales & Pamela Soto-Santillán

  2. Department of Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico

    Mario García-Carrasco & Claudia Mendoza-Pinto

  3. State Research Department, Instituto Mexicano del Seguro Social, Puebla, Mexico

    Socorro Méndez-Martínez

  4. Jefatura de División de Investigación en Salud, UMAE, Hospital de Traumatología, Instituto Mexicano del Seguro Social, Puebla, Puebla, Mexico

    Álvaro Montiel-Jarquín

  5. Cuerpo Académico de Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico

    Miguel Angel Enriquez-Guerra

  6. Secretary of Research and Postgraduate Studies, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico

    Margarita Muñóz-Guarneros

  7. Immunology Department, Hospital Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Puebla, Mexico

    José Luis Gálvez-Romero

  8. Department of Autoimmune Diseases, Hospital Clinic, Catalonia, Spain

    Ricard Cervera

Authors
  1. Mario García-Carrasco
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  2. Claudia Mendoza-Pinto
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  8. Margarita Muñóz-Guarneros
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Corresponding author

Correspondence to Claudia Mendoza-Pinto.

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Conflict of interest

Mario García-Carrasco, Claudia Mendoza-Pinto, María de la Luz León-Vázquez, Socorro Méndez-Martínez, Ivet Etchegaray-Morales, Álvaro Montiel-Jarquín, Miguel Angel Enriquez-Guerra, Margarita Muñóz-Guarneros, José Luis Gálvez-Romero, Pamela Soto-Santillán and Ricard Cervera declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The study was reviewed and approved by our local institutional ethics committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration.

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García-Carrasco, M., Mendoza-Pinto, C., León-Vázquez, M.d. et al. Incidence of Vertebral Fractures in Women with Systemic Lupus Erythematosus After 8 Years of Follow-Up. Calcif Tissue Int 101, 291–299 (2017). https://doi.org/10.1007/s00223-017-0286-z

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