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

Background: Patients with systemic lupus erythematosus (SLE) are at increased risk of osteoporosis. Despite this, the awareness of adequate dietary calcium intake and other prevention strategies is often underrecognized in clinical practice and guidelines. Methods: Dietary calcium intake was assessed using the ADOS-Ca questionnaire, validated for the Polish population, in SLE patients recruited both in person and online from various outpatient clinics. Data on vitamin D supplementation, awareness of osteoporosis risk, and preventive actions initiated by healthcare providers were also collected. Results: Median dietary calcium intake was 540 mg/day, below the recommended ≥1,000 mg or ≥1,200 mg (depending on age and sex). Only 25% of patients met these recommendations, including the subgroup of chronically taking glucocorticoids. Calcium supplementation was used by 31% of respondents on long-term glucocorticoid therapy. Regular vitamin D supplementation was reported by 79% of participants. Calcium and vitamin D intake and supplementation did not differ between patients treated and untreated with glucocorticoids. While 57% were aware of their elevated osteoporosis risk, only 32% had received guidance on preventive measures. Conclusion: Greater attention to osteoporosis prevention is needed among SLE patients, both from healthcare professionals and the patients themselves. The first and most fundamental step is optimizing calcium intake through diet and supplementation, which is particularly important in undergoing long-term glucocorticoid therapy.