狼疮肾炎患者骨密度的相关性因素分析

詹晓娜; 杨毅; 徐钢

doi:10.3969/j.issn.1671-2390.2024.01.004

狼疮肾炎患者骨密度的相关性因素分析

Analysis of factors associated with bone mineral density in patients with lupus nephritis

摘要

摘要:
目的过往报道中关于狼疮肾炎（lupus nephritis，LN）患者骨密度（bone mineral density，BMD）降低的患病率差异较大，本研究旨在探究LN患者BMD的相关因素。
方法纳入2016年5月1日至2022年6月30日在华中科技大学同济医学院附属同济医院进行BMD检测的LN患者。所有患者均使用双能X射线骨密度仪测量腰椎（L₁～L₄）、髋关节和股骨颈的BMD。
结果本研究共纳入91例LN患者，均为女性，年龄（47.2 ± 12.2）岁，60.4%的患者为绝经后患者，97.8%的患者服用糖皮质激素。69.2%的患者存在至少一个部位的BMD下降，63.7%的患者存在骨量减少，22.0%的患者存在骨质疏松。所有患者中，87.9%的患者接受钙剂治疗，35.2%的患者接受α骨化三醇治疗，53.8%的患者接受双磷酸盐治疗。多元线性回归分析显示，体重是腰椎（L₁～L₄，β = 0.008，P＜0.001）、髋关节（β = 0.016，P＜0.001）和股骨颈（β = 0.016，P＜0.001）BMD的独立相关因素，绝经时长是腰椎（L₁～L₄，β = −0.011，P = 0.038）和髋关节（β = −0.01，P = 0.017）BMD的独立相关因素。
结论 LN患者中BMD降低的患病率较高，体重和绝经时长可能是BMD的相关因素。

Abstract:
Objective There is a growing incidence of lower bone mineral density （BMD） in patients with lupus nephritis （LN）. The goal of this study was to explore the possible related factors of BMD in LN patients.
Methods Between May 2016 and June 2022, BMD was measured by dual X-ray absorptiometry （DXA） at lumbar spines of L₁～L₄, total hip and femoral neck in 91 female patients.
Results The mean age was 47.2 years. And 60.4% of them were postmenopausal and 97.8% received glucocorticoids. There were low BMD （69.2%）, osteopenia （63.7%） and osteoporosis （22.0%）. For preventing osteoporosis, the medications included calcium （87.9%）, α calcitriol （35.2%） and bisphosphonates （53.8%）. Multiple linear regression analysis revealed that body weight was an independent correlation factor for BMD of lumbar spine （L₁～L₄）（β = 0.008, P＜0.001）, total hip （β = 0.016, P＜0.001） and femoral neck （β = 0.016, P＜0.001）. And menopausal duration was an independent correlation factor for BMD of lumbar spine （L₁～L₄）（β = −0.011, P = 0.038） and total hip （β = −0.01, P = 0.017）.
Conclusions LN patients have a high prevalence of lower BMD. Low body weight and menopause duration may be the possible associated factors of BMD.

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