***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Systemic lupus erythematosus ( SLE ) is an autoimmune disease characterized by chronic inflammation . Different studies have shown decreased bone mineral density ( BMD ) in patients with SLE . The objective of this study was to investigate the prevalence and possible risk factors of low BMD in untreated female patients with SLE in Chinese population . A total of 119 untreated female patients with SLE were included . BMD was measured at lumbar spine and at total hip by dual-energy X-ray absorptiometry . The associations between decreased BMD and demographic variables , clinical variables , and bone metabolism variables were analyzed . These SLE patients had the following characteristics : mean age was 32.6 ± 11.9 years , mean disease duration was 22.1 ± 34.5 months , and mean SLEDAI was 11.4 ± 5.4 . Osteopenia was present in 31.1 % of the patients and osteoporosis in 8.5 % . A significant negative association between low density lipoprotein cholesterol ( LDL-c ) and BMD at the lumbar spine ( correlation coefficient = −0.242 ; P = 0.023 ) and total hip ( correlation coefficient = −0.259 ; P = 0.019 ) was shown . These results seem to indicate that increased LDL-c may be an important risk factor for low BMD at lumbar spine and total hip in untreated female SLE patients The aim of this study was to evaluate possible associations between potential risk factors and the occurrence of established vertebral fractures ( VF ) in Mexican patients with systemic lupus erythematosus ( SLE ) . Consecutive patients with SLE were enrolled in a prospect i ve , observational study from 2006 to 2015 . Information on potential risk factors , including demographics , clinical data , and bone mineral density ( BMD ) at the lumbar spine and hip on dual-energy X-ray absorptiometry was collected at baseline and follow-up . Semiquantitative analysis was used to determine incident VF on lateral thoracic and lumbar radiographs , defined as any vertebral body grade d normal at baseline and at least mildly deformed ( 20–25 % reduction or more in any vertebral height ) during follow-up . Differences in baseline characteristics were assessed in patients with and without new radiographic VF . Of 110 SLE patients included , with a median follow-up of 8 ( IQR 8–9 ) years , 22 ( 20 % ) had radiographic VF at baseline ; 35 ( 32 % ) patients had a new VF . The annual incidence rate of new morphometric VF was 3.5 ( 95 % CI 2.4–4.91 ) per 100 patient/years . Most fractures were mild or moderate and biconcave shaped . Incident VF were significantly associated with baseline BMD at the total hip and longer disease duration . Cumulative glucocorticoid dose , postmenopausal status , and previous prevalent VF were not associated with VF . In this SLE cohort in daily clinical practice , new VF were frequently present in SLE patients , especially those with longer disease duration and low-hip BMD Fractures and subsequent morbidity determine the impact of established postmenopausal osteoporosis .  Health-related quality of life ( HRQOL ) has become an important outcome criterion in the assessment and follow-up of osteoporotic patients . As part of the baseline measurements of the Multiple Outcomes of Raloxifene Evaluation ( MORE ) study , HRQOL was assessed in 751 osteoporotic ( bone mineral density [ BMD ] T score > or = -2.5 ) women from Europe with or without vertebral fractures ( VFX ) . This was done using the  quality of life question naire of the European Foundation for Osteoporosis ( QUALEFFO ) , Nottingham Health Profile ( NHP ) and the EQ-5D ( former EuroQol ) . QUALEFFO contains questions in five domains : pain , physical function , social function , general health perception , and mental function . Each domain score and QUALEFFO total scores are expressed on a 100-point scale , with 0 corresponding to the best HRQOL . In comparison with patients without VFX , those with VFX were older ( 66.2 + /- 5.9 years vs. 68.8 + /- 6.3 years ; p < 0.001 ) , had higher prevalence of nonvertebral fractures ( 25 % vs. 36 % ; p = 0.002 ) , and higher QUALEFFO scores ( worse HRQOL ; total score , 26 + /- 14 vs. 36 + /- 17 ; p < 0.001 ) . QUALEFFO scores increased progressively with increasing number of VFX , especially lumbar fractures ( p < 0.001 ) . Patients with a single VFX already had a significant increase in QUALEFFO scores ( p < 0.05 ) . Similar , though weaker , associations were seen for NHP and EQ-5D scores . This study confirms decreased HRQOL for patients with prevalent VFX . In osteoporotic patients , QUALEFFO scores change in relation to the number of VFX . QUALEFFO is suitable for clinical studies in patients with postmenopausal osteoporosis OBJECTIVE To evaluate predictors of vertebral fractures , including a threshold for bone mineral density ( BMD ) , in patients receiving oral glucocorticoids ( GCs ) .  METHODS Data were obtained from 2 r and omized clinical trials ( prevention and treatment trials of risedronate ) using similar methods , but different inclusion criteria were applied with regard to prior exposure to GCs . Predictors of vertebral fracture in the placebo group were identified using Cox regression with forward selection . The BMD threshold analysis involved a comparison of the 1-year fracture risk in postmenopausal women receiving placebo  in the GC trials with that in postmenopausal women not taking GCs  in 3 other trials . RESULTS The study population comprised 306 patients with baseline and 1-year followup data on vertebral fractures ( 111 receiving placebo and 195 receiving risedronate ) . In the placebo group , the statistically significant predictors of incident fracture were the baseline lumbar spine BMD ( for each 1-point decrease in T score , relative risk [ RR ] 1.85 , 95 % confidence interval [ 95 % CI ] 1.06 - 3.21 ) and the daily GC dose ( for each 10-mg dose increase , RR 1.62 , 95 % CI 1.11 - 2.36 ) . In the BMD threshold analysis , compared with nonusers of GCs , patients receiving GCs were younger , had a higher BMD at baseline , and had fewer prevalent fractures ; nevertheless , the risk of fracture was higher in the GC users compared with nonusers ( adjusted RR 5.67 , 95 % CI 2.57 - 12.54 ) . The increased risk of fracture was observed in GC users regardless of whether osteoporosis was present . CONCLUSION The daily , but not cumulative , GC dose was found to be a strong predictor of vertebral fracture in patients receiving GCs .  At similar levels of BMD , postmenopausal women taking GCs , as compared with nonusers of GCs , had considerably higher risks of fracture 
    Output:
    
Conclusions Patients with SLE had lower BMD than healthy controls .
Moreover , SLE patients with VF had lower BMD than patients without VF .
However , our data did not show that GCT therapy had an impact on BMD