Background/Purpose: Juvenile Systemic Lupus Erythematosus (jSLE) is a multisystem inflammatory disease associated with bone mass loss. This loss can be evaluated by using the bone mineral density (BMD), obtained from dual-energy X-ray absorptiometry (DXA). However, Trabecular Bone Score (TBS) is a new assessment method which is complementary to BMD, indicating the quality of bone microarchitecture, thereby aiding in the evaluation of the risk of fragility fractures. The primary objective of this study was to evaluate the TBS values obtained from DXA of children and adolescents diagnosed with jSLE and compare them with data from a sample of healthy individuals matched by age and sex. The secondary objectives were to associate TBS values with BMD; to evaluate risk factors that could influence TBS values in children and adolescents with jSLE, including clinical parameters and glucocorticoid (GC) use; and to assess the presence of fragility fractures.

Methods: An observational analytical retrospective study was conducted involving children and adolescents with jSLE aged between 5 and 19 years. Clinical data and BMD values obtained by DXA between 2017 and 2022 at a quaternary care health service, were analyzed. The BMD and TBS data of these patients were compared with existing published data of healthy Brazilian children and adolescents, after appropriate matching, for better interpretation of possible bone mass reduction.

Results: Ninety-four exams from 50 patients were analyzed. Twenty-one exams showed altered TBS. Overall, patients with jSLE had lower TBS values (mean, -0.067 ± 0.113, p-value < 0.0001). TBS was lower in female patients aged 14-16 and 17-19 years compared to their peers (p< 0.0001 and p=0.0004, respectively). BMD and TBS were concordant in 80/94 (85.1%) exams, with a moderate and positive correlation (Matthews correlation coefficient ϕ = 0.56, p < 0.0001). There was no correlation between lower TBS values and the presence of fractures (Matthews correlation coefficient ϕ = 0.0167, p < 0.871). No association was observed between TBS values and: disease duration, high disease activity, cumulative GC dose, or presence of fragility fractures.

Conclusion: TBS in patients with jSLE was lower than in healthy children and adolescents. 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluationofbone-mineral-densityand-trabecular-bone-score-in-juvenilesystemiclupuserythematosuspatientsusing-dual-energy-x-rayabsorptiometry/