The importance of inflammation and vitamin D status in SLE-associated osteoporosis

Epidemiological studies demonstrate an increased prevalence of low bone mineral density (BMD) and fragility fracture among systemic lupus erythematosus (SLE) patients in comparison to the general population. Although corticosteroid usage is a common cause of low BMD in this patient population, there is evidence that other factors are also involved. Recent publications have demonstrated an association between the inflammatory nature of SLE and low BMD. Inflammation can adversely alter bone metabolism, leading to a detrimental effect on bone material and structure. In addition, several reports have highlighted the prevalence of inadequate vitamin D status among the SLE patient population. Inadequate vitamin D status can compound the problem of low BMD, leading to increased bone fragility among SLE patients.