Skip to content

Advertisement

  • Poster presentation
  • Open Access

Identification of predictors of bone mineral density trajectories in pediatric Systemic Lupus Erythematosus patients

Pediatric Rheumatology20119 (Suppl 1) :P262

https://doi.org/10.1186/1546-0096-9-S1-P262

  • Published:

Keywords

  • Bone Mineral Density
  • Systemic Lupus Erythematosus
  • Systemic Lupus Erythematosus Patient
  • Lumbar Spine Bone Mineral Density
  • Bone Mineral Density Change

Background

Children with pediatric Systemic Lupus Erythematosus (pSLE) are at risk of low bone mass. No previous study had focused on longitudinal changes in bone mineral density (BMD) among children with pSLE from diagnosis.

Aims

1) To identify the trajectories of lumbar spine (LS) BMD in pSLE patients and 2) To identify predictors of this change in BMD over time.

Methods

All 68 newly diagnosed patients with pSLE prospectively followed in our Lupus clinic cohort who had 3 serial Dual Energy X-ray Absorptiometry (DEXA) examinations were studied. Low lumbar spine (LS) BMD was defined as z-score ≤ -2.0. Trajectory of LS BMD change and predictors of this change were assessed by Hierarchical Linear Modeling (HLM).

Results

Females constituted 84% of the cohort with a median age at diagnosis of 13.1 years. The mean LS BMD z-scores decreased with time. Initially, 9% of patients had a low BMD, this proportion increased to 19% by 3 years after diagnosis. Overall, the BMD category decreased in 35% of patients from 1st to 3rd DEXA study. LS BMD followed a general deteriorating trajectory of -0.25 z-score/year from diagnosis. Body mass index (BMI) z-score and cumulative steroid dose were the best predictors of BMD trajectories over time.

Conclusions

The LS BMD of pSLE patients decreased at a rate of 0.25 z-score/year. BMI z-score and cumulative doses of steroids modified the trajectories of LS BMD. These factors are potentially modifiable targets that can improve individual patient’s BMD trajectory.

Authors’ Affiliations

(1)
Division of Rheumatology, Toronto, Canada
(2)
Division of Nuclear Medicine, Toronto, Canada

Copyright

© Lim et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement