Prevalence of reduced bone mineral density in systemic lupus erythematosus and the role of steroids

Objective. To determine the prevalence of reduced bone mineral density (BMD) in a large female cohort of systemic lupus erythematosus (SLE) and to determine the role of steroids and disease related variables. Methods. Ail females with SLE managed by rheumatologists affiliated with a single tenter were invited to undergo BMD measurement of the lumbar spine and left femoral neck by dual energy X-ray absorptiometry (DEXA), standardized examination, and medical record review, Results. Ninety-seven females with a mean (SD) age of 44.2 (14.9) years were studied, Low bone mass [defined as BMD > 1 standard deviation (SD) below young adult mean] wart present in 44.3 and 42.1% at the lumbar spine and femoral neck? respectively, Osteoporosis (defined as BMD > 2.5 SD below young adult mean) was present in 13.4 and 6.3% at the lumbar spine and femoral neck, respectively, Steroid usage showed a strong inverse relationship with BMD in the lumbar spine, but a less strong relationship in the femoral neck, Conclusion. The findings of high prevalence of reduced BMD and association with steroid therapy have important implications for the routine management of SLE.