Abstract: Objective To investigate the changes of bone metabolism in different durations of glucocorticoid(GC)treatment of systemtic lupus erythematosus(SLE), and to explore the therapeutic schedule of glucocorticoid-induced osteoporosis(GIOP). Methods A total of 117 pre-menopausal women with SLE were involved as the observation group and 21 healthy pre-menopausal women served as the control group. According to the duration of GC therapy, the patients were divided into 7 subgroups: group Ⅰ(medication for 1~6 months), group Ⅱ(medication for 7~12 months), group Ⅲ(medication for 13~18 months), group Ⅳ(medication for 19~24 months), group Ⅴ(medication for 25~30 months), group Ⅵ(medication for 31~36 months), and group Ⅶ(medication for >36 months). The contents of amino-terminal-propeptide of type I collagen(T-PINT), amino-terminal of osteocalcin(N-MIDOs), type I collagen cross-linked C-telopeptide degradation fragments(β-CTX)and bone mineral density(BMD)of all subjects were measured. Results The serum β-CTX level was significantly elevated in group Ⅰ, Ⅱ and Ⅲ, and remark- 山 东 大 学 学 报 (医 学 版)55卷5期 -徐大霞,等.糖皮质激素性骨质疏松症骨代谢与糖皮质激素用药时间的相关性 \=-ably reduced in group Ⅵ and Ⅶ compared with the control group(P<0.05), while there was no difference in group Ⅳ and V(P>0.05). The serum levels of T-PINT and N-MIDOs in all subgroups were significantly lower than those in the control group(P<0.05). The BMD of patients receiving more than 6-month GC therapy was significantly lower than that of healthy controls(P<0.05). Conclusion In conclusion, the change of bone metabolism is from high decomposition to low decomposition and low osteogenesis in the process of GIOP formation. In the first 18 months of GC therapy, bone metabolism is in the state of low osteogenesis and high decomposition; after 30 months, it is in the state of low osteogenesis and low decomposition.

Key words: Glucocorticoid-induced osteoporosis, Systemic lupus erythematosus Glucocorticoid, Bone metabolism, Bone mineral density