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Low bone mineral density is present in newly diagnosed paediatric systemic lupus erythematosus patients

Siok Hoon Lily Lim1, Susanne M Benseler, Pascal N Tyrrell

  • 1Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Annals of the Rheumatic Diseases
|September 16, 2011
PubMed

Insights

One in six children newly diagnosed with paediatric systemic lupus erythematosus (pSLE) have low bone mineral density (BMD). Low BMI z score, calcium, and high iPTH indicate risk for low BMD at diagnosis.

Area of Science:

  • Pediatric Rheumatology
  • Bone Metabolism
  • Systemic Lupus Erythematosus

Background:

  • Paediatric systemic lupus erythematosus (pSLE) is a chronic autoimmune disease affecting children.
  • Low bone mineral density (BMD) is a potential complication in patients with chronic inflammatory diseases.
  • Understanding BMD prevalence and risk factors in newly diagnosed pSLE is crucial for early intervention.

Purpose of the Study:

  • To determine the prevalence of low bone mineral density (BMD) in newly diagnosed paediatric systemic lupus erythematosus (pSLE) patients.
  • To identify demographic, clinical, and biochemical risk factors associated with low BMD at diagnosis.

Main Methods:

  • A single-centre cohort study included 80 children and adolescents diagnosed with pSLE.
  • Dual-energy x-ray absorptiometry (DXA) was performed within 3 months of diagnosis to assess BMD.
  • Statistical analyses, including univariable and multivariable regression, identified risk factors for low BMD.

Main Results:

  • 15% of newly diagnosed pSLE patients exhibited low BMD at any site.
  • Lumbar spine BMD correlated with body mass index (BMI) z score and corrected calcium.
  • Hip BMD correlated with BMI z score and intact parathyroid hormone (iPTH); higher BMI z score was protective.

Conclusions:

  • Approximately one in six newly diagnosed pSLE patients presents with low BMD.
  • Low BMI z score, low serum calcium, and elevated iPTH levels are significant risk factors for low BMD at pSLE diagnosis.
  • These findings highlight the need for early BMD assessment and targeted interventions in pediatric lupus patients.
Abstract

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