Association of osteoporosis and cardiovascular disease in women with systemic lupus erythematosus

Objective. Young women with lupus are at increased risk for premature osteo porosis and cardiovascular disease. Experimental evidence suggests that inf lammation and immune-mediated mechanisms, key factors in the pathogenesis o f lupus, play a role in osteogenesis and atherogenesis. This study investig ated whether bone mineral density (BMD) was associated with the carotid pla que index, intima media thickness (IMT), or coronary artery calcium score i n lupus patients. Methods. In this pilot study, 65 women with lupus underwent carotid B-mode ultrasound to measure the carotid plaque index and IMT, and dual x-ray abso rptiometry to measure BMD at the lumbar spine and hip. As part of a feasibi lity study, 13 of these 65 patients also underwent electron-beam computed t omography to assess coronary artery calcification. Results. The carotid plaque index was higher (1.00, 1.00, and 0.38, respect ively) in the patients in the lowest and middle tertiles of hip BMD when co mpared with patients in the highest tertile of hip BMD. The correlation coe fficient between the coronary artery calcium score and lumbar spine BMD was -0.57 (P = 0.04), and between the coronary artery calcium score and hip BM D was -0.55 (P = 0.05). Conclusion. These results demonstrate an association between decreased BMD and both an increased carotid plaque index and presence of coronary artery calcification in a small cohort of young women with lupus.