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Licensed Unlicensed Requires Authentication Published by De Gruyter November 18, 2021

Predictors of decreased bone mineral density in childhood systemic lupus erythematosus: possible role of osteoprotegerin gene polymorphisms

  • Riham Eid ORCID logo EMAIL logo , Maha Abdelsalam , Aya A Fathy , Dena M Abd-El Ghaffar , Eman B Elmarghany , Aya A El-Hanafy , Nora Mostafa , Nashwa Hamdy ORCID logo , Nermeen A Niazy , Ayman Hammad ORCID logo and Hadil M Abolenein

Abstract

Objectives

This study aims to explore effects of osteoprotegerin (OPG) gene polymorphisms and other possible factors on bone mineral density (BMD) in children with systemic lupus erythematosus (SLE).

Methods

Osteoprotegerin gene rs2073617 and rs3134069 were evaluated in 74 SLE patients and 100 controls then genotypes, alleles and haplotypes’ frequencies were compared between cases and controls and between patients with BMD z-scores above and below −2 evaluated by dual energy X-ray absorptiometry (DEXA). Disease activity was evaluated by SLE disease activity index (SLEDAI).

Results

The patients aged 14.01 ± 2.6 years and included 57 (77%) females and 27 (36%) patients with BMD z-score below −2. Genotypes, alleles, and haplotypes frequencies did not differ between patients and controls (p>0.05 for all). Rs3134069 GG genotype and G allele (p=0.001, 0.002) and rs2073617 TT genotype and T allele (p=0.01, 0.006) were significantly higher in patients with BMD below −2. Cumulative glucocorticoids dose, disease duration, and SLEDAI scores were higher in patients with BMD below −2 (p=0.01, 0.01, <0.001, respectively). Regression analysis showed T allele of rs2073617, duration of illness (above 36 months), and cumulative SLEDAI (above 10) as independent predictors of decreased BMD (p 0.02, 0.003, and 0.002, respectively).

Conclusions

This is the first study to demonstrate OPG gene influence on BMD in children with SLE. The studied SNPs are not risk for developing SLE but, rs2073617 T allele is a possible predictor for reduced BMD in SLE. Other predictors include long disease duration and high activity supporting that osteoporosis in SLE is multifactorial.


Corresponding author: Dr. Riham Eid, Lecturer of Pediatrics/Nephrology, Nephrology Unit, Mansoura University Children’s Hospital, Mansoura Faculty of Medicine, Mansoura, 35561, Egypt, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was reviewed and approved by Mansoura Faculty of Medicine Institutional Research Board (MFM-IRB) (R.20.08.989).

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Received: 2021-07-23
Accepted: 2021-11-02
Published Online: 2021-11-18
Published in Print: 2022-01-27

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