Abstract
Abstract Objectives: The objective of this study was to determine the prevalence of low bone mineral density (BMD) in patients with systemic lupus erythematosus (SLE) and evaluate potential risk factors. Methods: A retrospective observational study of 144 patients with SLE who had at least one BMD test through dual-energy X-ray absorptiometry (DEXA) scan was conducted at King Saud Medical City and Prince Sultan Military Medical City in Riyadh, Saudi Arabia, between April 19, 2022, and April 18, 2023. Multivariate linear regression analyses were performed to determine the risk factors for low BMD. Results: The study included 144 SLE patients. The prevalence of low BMD was 53.3%. Low bone mass prevalence (defined as a Z-score <−2.0 in premenopausal women and men younger than 50 years), osteopenia, and osteoporosis were 29.9%, 13.2%, and 10.4%, respectively. There were 5.6% patients with fragility fractures, 75% vertebral fractures, and 25% peripheral fractures. Older age, postmenopausal status, arthritis, and high cumulative glucocorticoid dose were associated with low BMD. Immunosuppressive agents are protected against low BMD. In multivariate linear regression analyses, postmenopausal status remained a risk factor for low BMD. Conclusions: Patients with SLE are at a high risk of having low BMD. The majority exhibit low bone mass rather than osteopenia or osteoporosis, with the most common fractures occurring in the vertebrae. Notably, postmenopausal status represents a major risk factor for low BMD in patients with SLE.
Published Version
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