EPIDEMIOLOGY OF OSTEOPOROSIS IN WOMEN WITH LUPUS

系统性狼疮曾被认为是年轻女性的致命疾病， 但病人的死亡率和发病率在过去的一年里有了显著的改善， 十年 随着狼疮女性接近正常的预期寿命， 有低骨矿物质密度（BMD）的风险。 的精确 白种人和非裔美国妇女中低BMD的频率 与SLE是未知的，虽然初步证据已记录 高加索女性低BMD和骨折的频率增加 狼疮狼疮患者骨密度低的原因尚不清楚。 对非裔美国妇女的BMD或骨折知之甚少， 尽管这个种族群体患有狼疮三型， 是白人女性的四倍 虽然皮质类固醇 可能发挥作用，但有证据表明，它们可能不如 其他疾病因素或传统骨质疏松风险因素的改变 根据诊断和治疗。 本项目的总体目标 项目是进行横向研究和纵向研究 研究确定狼疮对低BMD的影响， 256名狼疮女性和256名健康女性的骨质流失 年龄、性别、种族和绝经状态相匹配的对照组。 BMD 在髋关节和腰椎，所有风险因素将在 进入研究和随访两年后。有待研究的风险因素 包括：1）传统的骨质疏松症危险因素，可能受到 疾病和/或其治疗的后果（生殖 病史、月经和绝经状态、口服避孕药的使用 和/或激素替代疗法，体力活动和维生素D 2）疾病特异性风险因素（疾病活动、疾病 严重程度和肾脏疾病）;和3）治疗相关的风险因素 （皮质类固醇和抗惊厥药）。 将使用t- 测试，分类和回归树（CART），以及相关性和 多元回归分析 这项研究将有助于开展工作 其他研究者通过;检查BMD和 潜在可逆或可预防的低BMD风险因素。这 信息将指导干预战略的制定， 预防这些高危患者的低BMD和随后的骨折。

Systemic lupus was once considered a fatal disease in young women, but patient mortality and morbidi have significantly improved in the last decade. As women with lupus approach a normal life expectancy, they are at risk for low bone mineral density (BMD). The precise frequency of low BMD in Caucasian and African-American women with SLE is unknown, although preliminary evidence has documented an increased frequency of low BMD and fractures in Caucasian women with lupus. The reasons for low BMD in lupus patients are unclear. Little is known on BMD or fractures in African-American women with lupus despite the fact that this racial group is afflicted by lupus three to four times as often as Caucasian women. Although corticosteroids may play a role, there is evidence that they may not be as important as other disease factors or alteration of traditional osteoporosis risk factor consequent to diagnosis and treatment. The overall goals of this project are to conduct both a cross-sectional study and a longitudinal study to determine the effect of lupus on low BMD and the rate of bone loss in 256 women with lupus and 256 close friend healthy controls matched for age, gender, race, and menopause status. BMD at the hip and lumbar spine and all risk factors will be measured at study entry and after two years of follow-up. Risk factors to be studied include: 1) traditional osteoporosis risk factors that may be affected by the consequences of the disease and/or its treatment (reproductive history, menstrual and menopause status, use of oral contraceptives and/or hormone replacement therapy, physical activity, and vitamin D levels); 2) disease specific risk factors (disease activity, disease severity, and renal disease); and 3) treatment related risk factors (corticosteroids and anticonvulsants). Data will be analyzed using t- tests, classification and regression trees (CART), and correlation and multiple regression analyses. This study will contribute to work done by other investigators by; examining the relationship between BMD and potentially reversible or preventable risk factors for low BMD. This information will direct the development of intervention strategies to prevent low BMD and subsequent fracture in these high risk patients.