LOSS OF BONE-MINERAL DENSITY IN CHINESE PREMENOPAUSAL WOMEN WITH SYSTEMIC LUPUS-ERYTHEMATOSUS TREATED WITH CORTICOSTEROIDS

The adverse effect of disease and chronic corticosteroid therapy or! b one mineral density (BMD) in patients with systemic lupus erythematosu s (SLE) has been reported in several studies of Caucasian populations. As the factors controlling bone homeostasis may be different in Asian populations. we measured BMD in 52 pre-menopausal Chinese women (mean age 34.1 +/- 8.0 yr) with SLE (mean disease duration 6.4 +/- 4.5 yr) treated with prednisone (mean daily dose 11.4 +/- 10.8 mg/day). Lumbar spine, hip (total and subregions) and total body BMDs were measured i n the SLE patients using dual-energy X-ray absorptiometry (DEXA), and compared with those from healthy controls matched for age, sex and bod y mass index. Compared to controls, SLE patients were found to have lo wer BMD (g/cm(2)) at several sites: the lumbar spine (0.98 vs 0.90, P = 0.001), Ward's triangle (0.72 vs 0.67, P = 0.03), total body (1.04 v s 1.01, P = 0.04) and total hip (0.87 vs 0.82, P = 0.05). There was no correlation between BMD at any region and duration of disease, activi ty of disease or prednisone therapy (mean daily dose, cumulative dose or treatment duration). When BMDs were compared between controls and S LE patients, subgrouped according to those not on calcium and those ar bitrarily receiving calcium supplements (1 g/day), significantly lower BMDs were found in those not on calcium compared to both controls and SLE patients on calcium. BMDs in SLE patients on calcium were not dif ferent from those in controls. The low prevalence of osteoporosis in o ur SLE patients (4-6%) suggests significant loss of BMD in Chinese SLE patients on corticosteroid therapy is less than that reported in Cauc asians (12-18%).