Prevalence and determinants of vertebral fractures in a SLE cohort.

IF 3.5 2区 医学 Q1 RHEUMATOLOGY
Denise Rotta, Giovanni Adami, Isotta Galvagni, Francesca Pistillo, Angelo Fassio, Davide Gatti, Margherita Zen, Viviana Ravagnani, Federica Maiolini, Jacopo Croce, Alessandro Volpe, Carmela Dartizio, Camilla Benini, Francesca Ruzzon, Ombretta Viapiana, Maurizio Rossini, Giovanni Orsolini
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引用次数: 0

Abstract

Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by multiorgan involvement. Osteoporosis and fragility fractures, particularly vertebral fractures, are significant, yet often underestimated, comorbidities in patients with SLE. This study aims to evaluate the prevalence of vertebral fractures and their associations with demographic, disease-related and therapy-related factors in patients with SLE.

Methods: We conducted a monocentric, cross-sectional study to systematically evaluate bone health using dual-energy X-ray absorptiometry and vertebral fracture assessment (VFA). Associations between vertebral fractures and clinical, laboratory variables were investigated with logistic and linear regressions.

Results: One hundred and six patients with SLE were included. The overall prevalence of radiographic vertebral fractures was 21.7%, whereas clinical vertebral fractures were reported in 14.2% of patients. New, previously not diagnosed, radiographic vertebral fractures were detected in 14.2% of all patients with SLE at screening with VFA. Older age, longer disease duration, cumulative glucocorticoid (GC) dose and lower bone mineral density were significantly associated with vertebral fractures. Cumulative GC dose had the strongest association with vertebral fractures. We also found a positive association between the number of vertebral fractures on VFA and cumulative GC dose (β 0.025, p=0.025).

Conclusions: Our findings underscore the importance of actively screening for vertebral fractures in patients with SLE, especially those on long-term GC therapy, to prevent underdiagnosis, mitigate the risk of further skeletal damage and facilitate the timely initiation of targeted antiosteoporotic treatments when indicated.

Trial registration number: NCT05590390.

Abstract Image

Abstract Image

SLE队列中椎体骨折的患病率和决定因素。
目的:系统性红斑狼疮(SLE)是一种以多器官受累为特征的慢性自身免疫性疾病。骨质疏松和脆性骨折,特别是椎体骨折,是SLE患者的重要合并症,但往往被低估。本研究旨在评估SLE患者椎体骨折的患病率及其与人口统计学、疾病相关和治疗相关因素的关系。方法:我们进行了一项单中心、横断面研究,利用双能x线吸收仪和椎体骨折评估(VFA)系统地评估骨骼健康。椎体骨折与临床、实验室变量之间的关系通过逻辑回归和线性回归进行了研究。结果:共纳入106例SLE患者。x线摄影椎体骨折的总体发生率为21.7%,而临床椎体骨折的发生率为14.2%。在VFA筛查的所有SLE患者中,14.2%的患者发现了新的、以前未诊断的影像学椎体骨折。年龄较大、病程较长、累积糖皮质激素(GC)剂量和较低的骨密度与椎体骨折显著相关。累积GC剂量与椎体骨折的相关性最强。我们还发现VFA椎体骨折数量与累积GC剂量呈正相关(β 0.025, p=0.025)。结论:我们的研究结果强调了积极筛查SLE患者椎体骨折的重要性,特别是那些长期接受GC治疗的患者,以防止漏诊,减轻进一步骨骼损伤的风险,并促进及时启动有针对性的抗骨质疏松治疗。试验注册号:NCT05590390。
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来源期刊
Lupus Science & Medicine
Lupus Science & Medicine RHEUMATOLOGY-
CiteScore
5.30
自引率
7.70%
发文量
88
审稿时长
15 weeks
期刊介绍: Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.
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