MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN MẬT ĐỘ XƯƠNG CỦA BỆNH NHÂN VIÊM CẦU THẬN LUPUS TẠI TRUNG TÂM DỊ ỨNG MIỄN DỊCH LÂM SÀNG - BỆNH VIỆN BẠCH MAI

Abstract

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that may compromise multiple organs. Lupus nephritis (LN) is a common complication of systemic lupus erythematosus (SLE) with an incidence of approximately 40-60%.¹ It is characterized by immune complex deposition in the kidneys, resulting in various clinical manifestations. Treatment of LN usually involves glucocorticoids and other immunosuppressive drugs. Glucocorticoid use has been extensively associated with reduced bone mineral density (BMD). Nevertheless, the contribution of corticosteroid therapy to bone loss in LN remains unclear as several studies found no association between reduced BMD and corticosteroid therapy.² Objectives: To assess factors influencing bone mineral density in patients with lupus nephritis. Subjects and Methods: A cross-sectional study was carried 112 patients with lupus nephritis at the Center of Allergology and Clinical Immunology, Bach Mai hospital from october, 2022 to october, 2023. Results: The average value of bone density at the femoral neck is 0,881 ± 0,122 g/cm²; in the pelvis areais 0,853 ± 0,131 g/cm². The percentage of patients with osteopenia accounted for 46,4%, osteoporosis accounted for 22,3%. BMD correlated weakly with body mass index in the lumbar spine (r = 0,241; p < 0,05) and in the femoral neck (r = 0,322; p < 0,01), estimated glomerular filtration rate in the lumbar spine (r = 0,305; p < 0,01), total corticosteroid duration in the femoral neck (r = - 0,313; p < 0,01), current corticosteroid dose in the lumbar spine (r = - 0,328; p < 0,001). Conclusion: BMD in patiens with LN is associated with some factors such as: body mass index, estimated glomerular filtration rate, current corticosteroid dose and total corticosteroid duration.