Objectives: To evaluate, in premenopausal systemic lupus erythematosus (SLE) patients, the possible protective role of androgens on bone mass.
Methods: Bone mineral density (BMD) was measured in the lumbar spine and femoral neck in 37 women with SLE (mean age 31.1 years) without disturbances or therapy that could interfere with bone metabolism except glucocorticoid therapy. We measured serum intact parathyroid hormone (iPTH): 2.5 +/- 1.3 pmol/L, serum testosterone: 1.6 +/- 1.1 nmol/L, salivary testosterone: 0.09 +/- 0.1 nmol/L, and serum dehydroepiandrosterone sulphate (DHEAS): 2.2 +/- 2.2 umol/L.
Results: BMD in the spine (L2-L4) was 0.94 +/- 0.1 g/cm2 and in the femoral neck 0.77 +/- 0.1 g/cm2. Four patients (10.8%) had osteoporosis. We found a significant positive relationship between DHEAS and BMD, a negative relationship between DHEAS and the glucocorticoid dose at the time of study, and a negative correlation between iPTH and DHEAS.
Conclusions: Bone loss in corticosteroid-treated premenopausal patients with SLE may be modulated through down-regulation of the endogenous production of DHEAS.