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High triglyceride is a risk factor for silent osteonecrosis of the femoral head in systemic lupus erythematosus

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Abstract

The purpose of this study was to clarify the factors related to silent osteonecrosis of the femoral head (ONFH) in patients with systemic lupus erythematosus (SLE). Seventy-eight patients with SLE were selected on the basis of having been newly diagnosed and requiring high-dose prednisolone, including pulse therapy with methylprednisolone, as the initial treatment. All the patients initially underwent MRI at 3 months after the start of corticosteroid treatment to detect any early changes in the femoral head. These examinations were then performed again 3 months later. Laboratory parameters were evaluated at the start of steroid treatment and at 1 month thereafter. By 3 months after the start of corticosteroid treatment, silent ONFH was diagnosed by MRI in 21 patients (26.9 %), being bilateral in 11 patients and unilateral in 10. The occurrence of silent ONFH was not related to SLE disease activity index, serological activity, or renal function; it was also unrelated to body mass index (BMI), body surface area (BSA), and the initial dose of prednisolone per unit body weight. However, the total cholesterol level at 4 weeks after the start of steroid treatment tended to be higher in patients with silent ONFH. Patients with a higher triglyceride level showed a significantly higher frequency of silent ONFH both before (p = 0.002) and 4 weeks after (p = 0.036) steroid initiation.

A high triglyceride level is an important risk factor for silent ONFH in patients with SLE, and large-scale epidemiologic surveys of such early events are needed in this patient population.

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Acknowledgments

This study was supported by a research grant from the Research Committee on Idiopathic Osteonecrosis of the Femoral Head of the Ministry of Health, Labour, and Welfare of Japan.

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Authors and Affiliations

  1. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan

    Takeshi Kuroda, Ayako Wakamatsu, Chinatsu Takai, Hiroe Sato, Takeshi Nakatsue, Yoko Wada & Ichiei Narita

  2. Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, 471 Ebigase, Higashi-ku, Niigata, 950-8680, Japan

    Naohito Tanabe

  3. Department of Medical Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8518, Japan

    Masaaki Nakano

Authors
  1. Takeshi Kuroda
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  2. Naohito Tanabe
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  3. Ayako Wakamatsu
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  4. Chinatsu Takai
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  5. Hiroe Sato
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  6. Takeshi Nakatsue
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  7. Yoko Wada
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  8. Masaaki Nakano
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  9. Ichiei Narita
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Correspondence to Takeshi Kuroda.

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Kuroda, T., Tanabe, N., Wakamatsu, A. et al. High triglyceride is a risk factor for silent osteonecrosis of the femoral head in systemic lupus erythematosus. Clin Rheumatol 34, 2071–2077 (2015). https://doi.org/10.1007/s10067-015-3075-y

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  • DOI: https://doi.org/10.1007/s10067-015-3075-y

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