狼疮患者的骨密度与年龄、治疗……

狼疮患者的骨密度与年龄、治疗及疾病本身有关

翻译：北医三院李欣艺（441580980@qq.com）
校正：张璐

摘要：系统性红斑狼疮患者因疾病本身因素或治疗因素，存在较高的骨量减低或骨质疏松的风险。骨质疏松或骨质疏松性骨折均具有致残性或致死性。此研究旨在探讨骨密度与狼疮疾病病程、年龄、性别、激素治疗之间的关系。腰椎及髋关节的骨密度通过双能X线进行检测。骨质疏松及骨量减少根据1994年世界卫生组织的相关定义进行划分。应用Mann-Whitney U检验进行数据统计分析。此研究纳入48名狼疮患者（其中44名女性，4名男性），平均年龄为45.8岁，平均疾病病程为9.8年。21%患者诊断为骨质疏松，15%患者诊断为骨量减低。骨量正常、低骨量以及骨质疏松的平均年龄分别是41.1岁、47.6岁、59.0岁。数据统计分析显示骨密度与年龄之间存在密切关系。骨密度正常的狼疮患者的疾病病程均很短，低骨密度患者的疾病病程平均为16.1年，骨质疏松的狼疮患者疾病病程平均为12.9年。纳入研究的患者大部分均有长期激素治疗史。1/3患者未服用ViD3治疗，56.3%患者未补钙治疗。狼疮患者骨密度减低的病理机制是多方面的，包括传统的骨质疏松的原因以及狼疮本身相关的因素。年龄、激素治疗均是狼疮患者出现低骨密度以及骨质疏松的主要原因。狼疮患者及时对低骨密度及骨质疏松的治疗对减低致残率及死亡率有重要作用。

附原文：Patients with systemic lupus erythematosus (SLE) are at an increased risk of developing low bone mass (LBM) or osteoporosis, either because of the disease itself or due to its treatment. Osteoporosis and osteoporotic fractures significantly contribute to morbidity and mortality. We aimed to determine the associations of bone mineral density (BMD) changes with the duration of SLE, age, gender, and glucocorticoid treatment in SLE patients treated at our Department.BMD measurements of the lumbar spine and total hip were performed by dual-energy X-ray absorptiometry (DXA). Osteoporosis and LBM were determined according to the 1994 World Health Organization definition. In the statistical analysis, the independent Mann-Whitney U test and Tukey post-hoc testing were used.The study included 48 SLE patients (44 female and 4 male), with a mean age of 45.8 years and an average SLE duration of 9.8 years. Osteoporosis was diagnosed in 21%, and LBM in 15% of the patients. The mean ages of the subgroups with normal BMD, LBM, and osteoporosis were 41.1, 47.6, and 59.0 years, respectively. Variant analysis showed a statistically significant correlation between age and BMD (p < 0.05). The duration of SLE was significantly shorter in patients with normal BMD (7.3 years), compared to patients with LBM (16.1 years) and osteoporosis (12.9 years) (p < 0.05). Nearly all patients (47 of 48) were on long-term treatment with glucocorticoids. One third (33.3 %) of patients did not take vitamin D3, and 56.3 % did not take calcium supplements. CONCLUSION: The etiopathogenesis of decreased BMD in SLE patients is multifactorial and includes both traditional and SLE-related risk factors. In our group of SLE patients age and glucocorticoid treatment were the major risk factors for LBM. Timely prevention and treatment of LBM and osteoporosis in SLE patients, according to current knowledge, are essential for reducing morbidity and mortality.
引自：Gracanin AG, Marković I, Loncarević J, Golob M, Morović-Vergles J. BONE MINERAL DENSITY IN PATIENT WITH SYSTEMIC LUPUSERYTHEMATOSUS--OUR RESULTS, Reumatizam.2015;62(2):16-21.