Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

Rheumatol Int. 2015 Mar;35(3):509-15. doi: 10.1007/s00296-014-3087-y. Epub 2014 Jul 17.


Studies have found an increase in bone loss and fracture in individuals with systemic lupus erythematosus (SLE) compared with general population. The aim of this study was to describe the prevalence of osteopenia, osteoporosis, and fragility fractures and to find potential predictors of bone loss in our cohort of SLE patients. We performed a cross-sectional study and collected 67 bone density measurements (BMD) of our SLE patients. We also collected sociodemographic data, 25-OH-vitamin D levels, serological markers, activity index, SLE cumulative damage index, and pharmacologic treatment. Sixty-seven consecutive BMD from SLE patients were assessed. Osteopenia was found in 28-46% of SLE patients. Osteoporosis ranged from 3 to 6%[corrected]. The only statistically significant correlation we found was between weight and height with total hip and femoral neck BMD (p < 0.05). The most frequent BMD-affected site was at the femoral neck, showing osteopenia in 40.3% [corrected] of SLE patients. Osteoporosis was found in up to 6% [corrected] of SLE patients. We found no predictors of bone loss in relation to the disease activity or its treatment. Fragility fractures were seen in 4.4% of SLE patients. All patients with fragility fractures showed osteopenia at BMD. There is a high prevalence of bone loss in SLE patients, since up to 40% [corrected] of SLE patients showed low BMD. Total hip and femoral neck osteopenia were the most frequent findings correlated with low BMI. We found a lower prevalence of fragility fractures compared with other series.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use
  • Bone Density
  • Bone Diseases, Metabolic / blood
  • Bone Diseases, Metabolic / diagnostic imaging
  • Bone Diseases, Metabolic / epidemiology
  • Cross-Sectional Studies
  • Female
  • Femur Neck / diagnostic imaging
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology*
  • Middle Aged
  • Osteoporosis / blood
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / epidemiology*
  • Osteoporotic Fractures / epidemiology*
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Spain / epidemiology
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood


  • Antirheumatic Agents
  • Immunosuppressive Agents
  • Vitamin D
  • 25-hydroxyvitamin D