Low prevalence of bone mineral density testing in patients with systemic lupus erythematosus and glucocorticoid exposure.
Low prevalence of bone mineral density testing in patients with systemic lupus erythematosus and glucocorticoid exposure.
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DOI：
10.1177/0961203320979735
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发表时间：
2021-03
期刊：
影响因子：
2.6
通讯作者：
Barnado A
中科院分区：
文献类型：
--
作者：
Boone JB;Wheless L;Camai A;Tanner SB;Barnado A
系统性红斑狼疮（SLE）患者由于全身性炎症和糖皮质激素（GC）而发生骨质疏松症和骨折的风险增加。专业机构建议在GCs上的SLE患者中进行骨矿物质密度（BMD）测试，特别是在开始后6个月内。使用经过验证的算法，我们在电子健康记录队列中确定了长期GC暴露（≥ 90天）的SLE患者。我们的主要结果是以往的BMD测试。我们评估了患者和供应商因素对测试的影响。我们确定了693例长期接触GC的SLE病例，其中41%进行了BMD检测。只有18%的患者在GC启动后6个月内进行了BMD测试。在BMD检测的逻辑回归模型中，调整种族和民族后，男性（OR = 0.49，95%CI 0.27 - 0.87，p = 0.01）与不太可能进行BMD检测相关。相比之下，年龄较大（OR = 1.04，p < 0.001）和肾炎（OR = 1.83，p = 0.003）与调整种族和种族后更可能进行BMD测试相关。SLE患者的骨骼健康仍然是一个需要改善的领域，需要关注年轻和男性患者。
Patients with systemic lupus erythematosus (SLE) have an increased risk of developing osteoporosis and fractures due to systemic inflammation and glucocorticoids (GCs). Professional organizations recommend bone mineral density (BMD) testing in SLE patients on GCs, especially within 6 months of initiation. Using a validated algorithm, we identified SLE patients in an electronic health record cohort with long-term GC exposure (≥ 90 days). Our primary outcome was ever BMD testing. We assessed the impact of patient and provider factors on testing. We identified 693 SLE cases with long-term GC exposure, 41% of whom had BMD testing performed. Only 18% of patients had BMD testing within 6 months of GC initiation. In a logistic regression model for BMD testing, male sex (OR = 0.49, 95% CI 0.27 – 0.87, p = 0.01) was associated with being less likely to have BMD testing after adjusting for race and ethnicity. In contrast, older age (OR = 1.04, p < 0.001) and nephritis (OR = 1.83, p = 0.003) were associated with being more likely to have BMD testing after adjusting for race and ethnicity. Bone health in SLE patients remains an area in need of improvement with attention to patients who are younger and male.
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影响因子：
--
作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, Graciela S.;Gordon, Caroline;Merrill, Joan T.;Fortin, Paul R.;Bruce, Ian N.;Isenberg, David;Wallace, Daniel J.;Nived, Ola;Sturfelt, Gunnar;Ramsey-Goldman, Rosalind;Bae, Sang-Cheol;Hanly, John G.;Sanchez-Guerrero, Jorge;Clarke, Ann;Aranow, Cynthia;Manzi, Susan;Urowitz, Murray;Gladman, Dafna;Kalunian, Kenneth;Costner, Melissa;Werth, Victoria P.;Zoma, Asad;Bernatsky, Sasha;Ruiz-Irastorza, Guillermo;Khamashta, Munther A.;Jacobsen, Soren;Buyon, Jill P.;Maddison, Peter;Dooley, Mary Anne;van vollenhoven, Ronald F.;Ginzler, Ellen;Stoll, Thomas;Peschken, Christine;Jorizzo, Joseph L.;Callen, Jeffrey P.;Lim, S. Sam;Fessler, Barri J.;Inanc, Murat;Kamen, Diane L.;Rahman, Anisur;Steinsson, Kristjan;Franks, Andrew G., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
通讯作者：
Magder, Laurence S.
影响因子：
13.3
作者：
Buckley, Lenore;Guyatt, Gordon;McAlindon, Timothy
通讯作者：
McAlindon, Timothy
影响因子：
4.7
作者：
Schmajuk, Gabriela;Yelin, Edward;Yazdany, Jinoos
通讯作者：
Yazdany, Jinoos
影响因子：
4
作者：
Cosman, F.;de Beur, S. J.;LeBoff, M. S.;Lewiecki, E. M.;Tanner, B.;Randall, S.;Lindsay, R.
通讯作者：
Lindsay, R.
影响因子：
6.7
作者：
Roden, D. M.;Pulley, J. M.;Masys, D. R.
通讯作者：
Masys, D. R.