THE ASSOCIATION OF DEHYDROEPIANDROSTERONE-SULFATE LEVELS WITH BONE-MINERAL DENSITY IN SYSTEMIC LUPUS-ERYTHEMATOSUS

Objectives: To evaluate, in premenopausal systemic lupus erythematosus (SLE) patients, the possible protective role of androgens on bone mas s. Methods: Bone mineral density (BMD) was measured in the lumbar spin e and femoral neck in 37 women with SLE (mean age 31.1 years) without disturbances or therapy that could interfere with bone metabolism exce pt glucocorticoid therapy. We measured serum intact parathyroid hormon e (iPTH): 2.5 +/- 1.3 pmol/L, serum testosterone: 1.6 +/- 1.1 nmol/L, salivary testosterone: 0.09 +/- 0.1 nmol/L, and serum dehydroepiandros terone sulphate (DHEAS): 2.2 +/- 2.2 umol/L. Results: BMD in the spine (L2 - L4) was 0.94 +/- 0.1 g/cm(2) and in the femoral neck 0.77 +/- 0 .1 g/cm(2). Four patients (10.8%) had osteoporosis. We found a signifi cant positive relationship between DHEAS and BMD, a negative relations hip between DHEAS and the glucocorticoid dose at the time of study, an d a negative correlation between iPTH and DHEAS. Conclusions: Bone los s in corticosteroid-treated premenopausal patients with SLE may be mod ulated through down-regulation of the endogenous production of DHEAS.