Bone Abstracts

Introduction: Although systemic lupus erythematosus (SLE) has traditionally been considered a disease of women, men may also be afected. Male osteoporosis is increasingly recognised. Several studies have reported that mean bone mineral density is significantly reduced in SLE women patients and most of them have low levels of vitamin D. The aim of our study is to analize this situation in men.

Objectives: Determine 25-hydroxyvitamin-D (25OHD) serum concentrations and the presence of osteoporosis in male patients with SLE.

Methods: Eight male patients SLE diagnosed and controlled in our department were included. In all patients were analyzed clinical and laboratory features (including PTH, 25OHD, 24 h urinary calcium excretion, complement (C3, C4), P1NP and βCTX); bone mineral density of lumbar spine (L1–L4) and femur was measured and spinal X-rays.

Results: Eight male patients with SLE with a mean age of 45.8 years (23–65). 75% receive calcium plus vitamin D supplements (500 mg of calcium and 400 UI of vitamin D (cholecalciferol)). Seven patients receive corticoids as a part of their SLE treatment and two of them receive biologic therapy.

Patients with SLE have average levels of 25OHD of 23.2 ng/ml (14.2–34.2). Insufficient vitamin D levels (25OHD <30 ng/ml) were observed in most patients (87.5%), 37.5% showed deficient levels (25OHD <20 ng/ml). Bone remodeling markers were within normal values P1NP 36.7 (18–134) ng/ml and βCTX 412 (143–797) pg/ml.

Three patients have decreased bone mass according to densitometric criteria. one vertebral fracture was registered.

Conclusions: High prevalence of 25OHD insufficeincy/deficiency was found in SLE male patients, despite treatment with calcium and vitamin D supplements, which indicates that these doses are insufficient. Almost 40% of these patients have decreased bone mass. These findings underline the importance of prevention and treatment of vitamin D deficiency and osteoporosis in male patients with SLE.