狼疮肾炎和u1 - rnp抗体与系统性红斑狼疮患者的低骨密度和骨质疏松症相关:炎症性风湿病患者亚队列的基线结果

IF 4.6 2区 医学 Q1 Medicine
Edgar Wiebe, Elisa Celine Schilling, Dörte Huscher, Andriko Palmowski, Zhivana Boyadzhieva, Sandra Hermann, Burkhard Muche, Mirella Lopez Picazo, Gerhard Krönke, Falk Hiepe, Tobias Alexander, Frank Buttgereit
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引用次数: 0

摘要

系统性红斑狼疮(SLE)患者发生骨质疏松和脆性骨折的风险较高。我们的研究旨在确定影响骨密度(BMD)和骨质疏松症风险的疾病特异性因素,并评估dxa衍生的3D股骨参数与BMD和骨小梁评分(TBS)在区分先前存在的脆性骨折方面的有效性。我们分析了目前或过去接受过GC治疗的SLE患者连续亚队列的基线数据,这些患者符合EULAR/ACR 2019 SLE分类标准。我们使用多变量线性和逻辑回归模型来确定骨密度和骨质疏松相关的因素。dxa衍生的股骨三维测量使用3D- shaper软件进行。通过AUC值评估脆性骨折的BMD、TBS和三维股骨参数的鉴别性能。110例SLE患者中有41%患有骨质疏松症。35%的病例存在狼疮性肾炎(LN),其中61%(23/38)主要被分类为IV级和v级。与BMD降低显著相关的因素包括III级和IV级LN、U1-RNP抗体、较高的c反应蛋白和较长的病程。临床缓解、较高的Siglec-1水平、较高的体重指数和较高的健康评估问卷(HAQ)评分与BMD呈正相关。骨质疏松症与LN、较高的年龄、HAQ和补体因子3水平有关。我们的研究结果表明,三维骨结构分析可能有助于区分过去的椎体骨折。LN、高CRP、U1-RNP抗体的存在以及疾病持续时间的延长表明疾病严重程度对骨骼健康有害。此外,3D-DXA参数可以整合到临床实践中来评估骨骼健康。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lupus nephritis and U1-RNP-antibodies are associated with low bone mineral density and osteoporosis in patients with systemic lupus erythematosus: baseline findings in a sub-cohort of patients with inflammatory rheumatic diseases
Patients with systemic lupus erythematosus (SLE) are at higher risk for osteoporosis and fragility fractures. Our study aimed to identify disease-specific factors with impact on bone mineral density (BMD) and the risk of osteoporosis, and to evaluate the effectiveness of DXA-derived 3D femur parameters versus BMD and trabecular bone score (TBS) in discriminating pre-existent fragility fractures. We analyzed baseline data of a consecutive subcohort of patients with SLE with current or past GC treatment, fulfilling the EULAR/ACR 2019 SLE classification criteria. We used multivariable linear and logistic regression models to identify BMD- and osteoporosis-related factors. DXA-derived 3D measurements of the femur were performed with 3D-Shaper software. Discriminatory performance of BMD, TBS and 3D femoral parameters for fragility fractures was assessed by AUC values. Forty-one percent of 110 patients with SLE had osteoporosis. Lupus nephritis (LN) was present in 35% of cases, with 61% (23/38) of these being predominantly classified as classes IV and V. Factors significantly associated with lower BMD included LN classes III and IV, U1-RNP antibodies, higher C-reactive protein, and longer disease duration. Clinical remission, higher Siglec-1 levels, higher body mass index, and higher health assessment questionnaire (HAQ) scores correlated positively with BMD. Osteoporosis was linked to LN, higher age, HAQ, and complement factor 3 levels. Our findings suggest that 3D bone structure analysis may be helpful in discriminating past vertebral fractures. Disease severity indicated by LN, high CRP, presence of U1-RNP antibodies, and extended disease duration are detrimental to bone health. Moreover, 3D-DXA parameters can be integrated in clinical practise to assess bone health.
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来源期刊
CiteScore
8.60
自引率
2.00%
发文量
261
审稿时长
14 weeks
期刊介绍: Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.
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