Bone mineral density and body composition in men with systemic lupus erythematosus: A case control study

Objective To study the bone mineral density (BMD) and body composition in men with systemic lupus erythematosus (SLE). Methods Consecutive male patients who fulfilled ≥ 4 ACR criteria for SLE and age-matched healthy men were recruited for measurement of BMD and body composition by DXA scan. Risk factors for low BMD in SLE patients were evaluated. Results 40 male SLE patients were studied (age 42.6 ± 12 years; disease duration 84.7 ± 79 months). 34 (85%) patients were treated with long-term glucocorticoids. Compared with 40 controls, SLE patients had a significantly lower BMD at the lumbar spine (0.96 ± 0.16 vs 1.03 ± 0.11 g/cm2; p = 0.02) and the hip (0.87 ± 0.14 vs 0.94 ± 0.12 g/cm2; p = 0.04). At the spine, 12 (30%) SLE patients had Z scores< − 2.0 and 2 (5%) had osteoporotic fractures. At the hip, 3 (7.5%) patients had Z scores< − 2.0 but none had hip fractures. The BMD Z scores at the femoral neck and spine were significantly lower in SLE patients than controls. The total lean body mass was also lower in patients than control subjects (46.4 ± 7.3 vs 50.5 ± 5.9 kg; p = 0.01). Multiple regression revealed increasing age, habitual drinking, lower BMI and use of high-dose prednisolone were unfavorably associated with lower BMD at the spine in SLE patients. Conclusions Reduced BMD and lean body mass are prevalent in men with SLE. Appropriate measures against osteoporosis should be undertaken, especially in older patients with low BMI who receive high-dose glucocorticoids.