Low calcium intake from diet and supplements in a group of Polish patients with SLE - an additional risk for osteoporotic fractures?

Median dietary calcium intake in SLE patients was substantially below recommended levels.

• Median dietary calcium intake was 540 mg/day.
• Recommended intake is ≥1,000 mg or ≥1,200 mg depending on age and sex.
• Dietary calcium intake was assessed using the ADOS-Ca questionnaire, validated for the Polish population.
• Patients were recruited both in person and online from various outpatient clinics.

Only one quarter of SLE patients met dietary calcium intake recommendations.

• Only 25% of patients met the recommended calcium intake.
• This low adherence to recommendations applied also to the subgroup of patients chronically taking glucocorticoids.
• Calcium and vitamin D intake and supplementation did not differ between patients treated and untreated with glucocorticoids.

Calcium supplementation use was low among SLE patients on long-term glucocorticoid therapy.

• Calcium supplementation was used by only 31% of respondents on long-term glucocorticoid therapy.
• Long-term glucocorticoid use is a recognized additional risk factor for osteoporosis in SLE patients.
• Calcium and vitamin D intake and supplementation did not differ between glucocorticoid-treated and untreated patients.

Vitamin D supplementation was more commonly reported than calcium supplementation among SLE patients.

• Regular vitamin D supplementation was reported by 79% of participants.
• This contrasts with the low rate of calcium supplementation (31% among those on glucocorticoids).
• Vitamin D supplementation rates did not differ between patients treated and untreated with glucocorticoids.

Awareness of osteoporosis risk was present in the majority of patients, but guidance on preventive measures was received by fewer than one-third.

• 57% of SLE patients were aware of their elevated osteoporosis risk.
• Only 32% had received guidance on preventive measures from healthcare providers.
• Data on awareness and preventive actions initiated by healthcare providers were collected as part of the study.

SLE patients are at increased risk of osteoporosis, yet awareness of adequate dietary calcium intake and prevention strategies is often underrecognized in clinical practice and guidelines.

• Patients with systemic lupus erythematosus are at increased risk of osteoporosis.
• Prevention strategies including adequate calcium intake are often underrecognized in clinical practice and guidelines.
• Long-term glucocorticoid therapy, commonly used in SLE, represents an additional osteoporosis risk factor.