Bone Strength Changes And Risk Factors In Women Patients With SLE Complicated With Osteoporosis

Objectives By collecting the basic conditions,disease history,hormone history,drug therapy history and bone strength of female patients with SLE,the distribution of bone strength and the risk factors associated with osteoporosis in female patients with SLE were discussed.Methods Female patients with SLE who were diagnosed from October 2010 to October2021 were selected,the strength of lumbar spine and hip bone was measured by DXA,and the osteoporosis group,bone loss group and normal bone mass group were divided according to the patient’s BMD results,and the basic conditions,disease history,hormone use history,drug treatment history and bone strength of each group were collected to analyze the osteoporosis disease of female patients with SLE.Based on the collected demographic and disease-related indicators,tthe distribution of bone strength and risk factors for complicated osteoporosis in female patients with SLE were studied.Results A total of 76 female patients with SLE were enrolled,including 33(43.4%)patients with osteoporosis,23 patients with bone loss(30.3%),and 20 patients with normal bone mass(26.3%).There were significant differences in patient age,BMI,course of illness,cumulative dose of hormones,and HCQ use in the three groups(P<0.05).1 Grouped by menopausal status,the BMD of the lumbar spine(L,L1-L4)and hip joint(femoral neck,intertrochanteric,hip)of the menopausal group decreased compared with the nonmenopausal group,and the bone strength parameters CSA,CSMI,Z and Cort of the narrow neck and intertrochanteric decreased,the BR increased,and the femoral shaft bone strength parameters CSA,Z and Cort decreased.BR was elevated(P<0.05);by age group,the lumbar spine(L,L1-L4)and hip joint(total femoral neck,intertrochanter,hip)in the older group(age>65 years)were all decreased(P<0.05),the narrow neck,intertrochanteric and femoral shaft bone strength parameters CSA,CSMI,and Z decreased,BR was elevated(P<0.05),grouped by disease duration,the longer course group(>10 years)was lower than the shorter course(≤10 years),lumbar spine(L,L1-L4)and hip joint(narrow neck,intertrochanteric,hip joint)BMD decreased,narrow neck bone strength parameters CSA and Cort decreased,intertrochanteric bone strength parameters CSA,CSMI,Cort and Z decreased,BR increased,femoral shaft bone strength parameter Cort decreased(P<0.05);according to whether HCQ was used,SLE patients with HCQ were classified as HCQ patients lumbar spine(L,L1-L4)and hip joint(femoral neck and hip)BMD were increased,narrow neck bone strength parameters CSA and Cort increased,BR decreased,intertrochanteric bone strength parameters Cort increased,BR decreased,femoral shaft bone strength parameters CSA and Cort increased,BR decreased(P<0.05);grouped by cumulative dose of glucocorticoids,patients with cumulative doses of>5g of lumbar spine(L,L1-L3)and hip joint(hip)BMD decreased,narrow neck bone strength parameters BR increased,intertrochanteric bone strength parameters Cort decreased,BR increased,femoral shaft bone strength parameters Cort decreased,BR is elevated(P<0.05).2 The proportion of osteopenia and osteoporosis decreased in patients using HCQ(χ~2=18.89,P<0.05);the age of patients was inversely correlated with their lumbar,hip BMD,and hip HSA parameters(P<0.01);patients’BMI was positively correlated with their lumbar spine,hip BMD,and hip HSA parameters(P<0.01);the duration of SLE disease was positively correlated with their lumbar spine,hip BMD,and hip HSA parameters.The inter-hip BMD and inter-hip HSA parameters were inversely correlated(P<0.05),and the cumulative dose of glucocorticoids in patients was inversely correlated with their lumbar BMD(P<0.05),but not related to hip bone strength.3 Advanced age(>65 years,OR=0.073,95%CI:0.015-0.343),and longer duration of SLE disease(duration>10 years,OR=0.087,95%CI:0.015-0.499)were independent risk factors for OP in women with SLE,while BMI>28(OR=11.123,95%CI:1.391-88.967)and applied HCQ(OR=7.929,95%CI:1.785-35.211)is its protective factor.Conclusions 1 SLE is one of the causes of secondary osteoporosis in women.2 Advanced age,low BMI,long SLE course,and cumulative dose of high glucocorticoids have negative effects on bone density and bone strength.3 High BMI and HCQ are protective factors for female patients with SLE who experience osteoporosis.Figure 0;Table 8;Reference 124...