Lower P1NP Serum Levels: a Predictive Marker of Bone Loss after One-Year Follow-up in premenopausal SLE Patients

Luciana Seguro¹, Caio B. Casella¹, Valéria Caparbo¹, Ricardo M. Oliveira², Alessandra C Bonfa¹, Eloisa Bonfa¹ and Rosa M R Pereira¹, ¹Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, ²RDO Diagnosticos Medicos, São Paulo, Brazil

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Bone density, bone metabolism, osteoporosis and systemic lupus erythematosus (SLE)

Session Information

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis: Osteoporosis: Pathogenesis, Epidemiology and Diagnosis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Systemic Lupus Erythematosus (SLE) is associated with high risk of low bone mass/fractures but this risk is still controversial in premenopausal women. Our aim was to determine the one-year incidence of bone mineral density (BMD) loss in premenopausal SLE women and the value of bone turnover markers as predictors of this complication.

Methods

This study enrolled a convenience sample of 63 premenopausal SLE patients. BMD was evaluated by dual X-ray absorptiometry at lumbar spine and hip at baseline and after 12 months. BMD changes above the least significant change were considered significant. Serum levels of P1NP and CTX (electrochemiluminescence), OPG and RANKL (ELISA) were determined at baseline.

Results

Mean age was 31.1±6.8years, disease duration was 5.25±3.8years. 36.5% of patients presented BMD loss and 17.5% BMD gain at lumbar spine and/or hip. Patients were divided in three groups: BMD loss (BL), no BMD change (NC) and BMD gain (BG). Patients with BL and NC received similar cumulative/mean/maximum glucocorticoid doses during the study, but patients with BG received lower doses (p<0.05). Baseline P1NP levels were different in the groups (BL:36.95±23.37 vs. NC:54.63±30.82 vs. BG:84.09±43.85 ng/ml; p=0.031 BL vs. NC, p<0.001 BL vs. BG and p=0.039 NC vs. BG). There was no difference in CTX, OPG or RANKL levels. After multivariate analysis P1NP remained as an independent risk factor for BMD loss (p<0.03).

Conclusion

This study provides original evidence that lower levels of P1NP, the most specific bone formation marker, are predictive of BMD loss over 12 months in premenopausal SLE patients.

Disclosure:

L. Seguro,
None;

C. B. Casella,
None;

V. Caparbo,
None;

R. M. Oliveira,
None;

A. C. Bonfa,
None;

E. Bonfa,
None;

R. M. R. Pereira,
None.

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