Prevalence of reduced bone mineral density in systemic lupus erythematosus and the role of steroids

J Rheumatol. 1997 Oct;24(10):1922-9.


Objective: To determine the prevalence of reduced bone mineral density (BMD) in a large female cohort of systemic lupus erythematosus (SLE) and to determine the role of steroids and disease related variables.

Methods: All females with SLE managed by rheumatologists affiliated with a single center were invited to undergo BMD measurement of the lumbar spine and left femoral neck by dual energy X-ray absorptiometry (DEXA), standardized examination, and medical record review.

Results: Ninety-seven females with a mean (SD) age of 44.2 (14.9) years were studied. Low bone mass [defined as BMD > 1 standard deviation (SD) below young adult mean] was present in 44.3 and 42.1% at the lumbar spine and femoral neck, respectively. Osteoporosis (defined as BMD > 2.5 SD below young adult mean) was present in 13.4 and 6.3% at the lumbar spine and femoral neck, respectively. Steroid usage showed a strong inverse relationship with BMD in the lumbar spine, but a less strong relationship in the femoral neck.

Conclusion: The findings of high prevalence of reduced BMD and association with steroid therapy have important implications for the routine management of SLE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Bone Density / drug effects*
  • Cohort Studies
  • Female
  • Femur Neck / diagnostic imaging
  • Femur Neck / drug effects
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / drug effects
  • Lupus Erythematosus, Systemic / diagnostic imaging*
  • Lupus Erythematosus, Systemic / drug therapy
  • Middle Aged
  • Steroids / adverse effects*
  • Steroids / therapeutic use


  • Steroids