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Diagnosis dan penatalaksanaan osteosarkopenia pada penderita sistemik lupus eritematosus

  • Dewa Ayu Kartika Tejawati ,
  • I Wayan Hendra Gunadi ,
  • Gede Kambayana ,
  • Ida Bagus Putu Putrawan ,
  • Pande Ketut Kurniari ,


The term osteosarcopenia has been coined to describe the concomitant occurrence of osteopenia/osteoporosis and sarcopenia. Osteosarcopenia can occur in patients with SLE due to the inflammatory process and long-term use of glucocorticoids which play a role in the pathophysiology of osteosarcopenia. Until now there is no definite recommendation regarding when to carry out early detection of osteosarcopenia in patients with SLE, but there is a recommendation to carry out screening after 3 months of long-term glucocorticoid use to determine the incidence of glucocorticoid-induced osteoporosis. The gold standard for assessing bone mass is dual X-ray absorptiometry (DXA). For prevention of osteosarcopenia, identification and treatment of modifiable risk factors such as endocrine disorders is essential. In addition, the risk of developing sarcopenia and osteopenia can be reduced through healthy lifestyle changes that optimize stem bone mass and maintain musculoskeletal health throughout life, including regular physical activity and adequate nutrition (intake of calcium, vitamin D and protein).


Istilah osteosarkopenia telah diciptakan untuk menggambarkan kejadian bersamaan dari osteopenia/osteoporosis dan sarkopenia. Osteosarkopenia dapat terjadi pada pasien SLE akibat proses inflamasi dan penggunaan glukokortikoid jangka panjang yang berperan dalam patofisiologi osteosarkopenia. Sampai saat ini belum ada anjuran pasti mengenai kapan harus dilakukan deteksi dini osteosarkopenia pada pasien SLE, namun ada anjuran untuk melakukan skrining setelah 3 bulan penggunaan glukokortikoid jangka panjang untuk mengetahui kejadian osteoporosis akibat glukokortikoid. Standar emas untuk menilai massa tulang adalah dual X-ray absorptiometry (DXA). Untuk pencegahan osteosarkopenia, identifikasi dan pengobatan faktor risiko yang dapat dimodifikasi seperti gangguan endokrin sangat penting. Selain itu, risiko terjadinya sarkopenia dan osteopenia dapat dikurangi melalui perubahan gaya hidup sehat yang mengoptimalkan massa tulang induk dan menjaga kesehatan muskuloskeletal sepanjang hidup, termasuk aktivitas fisik secara teratur dan nutrisi yang cukup (asupan kalsium, vitamin D, dan protein).


  1. Fatima M, Brennan-Olsen SL, Duque G. Therapeutic approaches to osteosarcopenia: insights for the clinician. Ther Adv Musculoskelet Dis 2019;11:1759720X1986700.
  2. Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int 2017;28:2781–90 http://link.
  3. Duque G. Osteosarcopenia: A Geriatric Giant of the XXI Century. J Nutr Health Aging. 2021;25(6):716-719.
  4. Paintin J, Cooper C, Dennison E. Osteosarcopenia. Br J Hosp Med (Lond). 2018 May 02; 79(5): 253–258.
  5. Radkowski MJ, Sławiński P, Targowski T. Osteosarcopenia in rheumatoid arthritis treated with glucocorticosteroids - essence, significance, consequences. Reumatologia. 2020;58(2):101-106. doi: 10.5114/reum.2020.95363. Epub 2020 Apr 30. PMID: 32476683; PMCID: PMC7249526.
  6. Yushu Huang, Yukang Li, Sean X. Leng, Chapter 6 - Inflammation and osteosarcopenia, Editor(s): Gustavo Duque, Bruce R. Troen, Osteosarcopenia,
  7. Elsevier, 2022, Pages 91-116, ISBN 9780128200889,
  8. Anggraini NS. 2016. Lupus eritematosus sistemik. Jurnal Medula Unila. 4(4):124-131.
  9. Schaap LA, Pluijm SMF, Deeg DJH, Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med. 2006; 119(6): 526.e9- 526.e17.
  10. Ju-Yang Jung, Sang Tae Choi, Sung-Hoon Park. Prevalence of osteoporosis in patients with systemic lupus erythematosus: A multicenter comparative study of the World Health Organization and fracture risk assessment tool criteria, Osteoporosis and Sarcopenia, Volume 6, Issue 4, 2020, Pages 173-178, ISSN 2405-5255,
  11. Kawao N, Kaji H. Interactions Between Muscle Tissues and Bone Metabolism. Journal of Cellular Biochemistry;2015:116:687–695.
  12. Lieber S, Paget S, Berman J, Barbhaiya M, Sammaritano L, Kirou K, et al. Frailty and Sarcopenia in Women with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2019;71 (suppl 10). Accessed January 10, 2023.
  13. Feklistov A, Demin N. Toroptsova NAB0330 Osteoporosis, sarcopenia and osteosarcopenia in women with rheumatoid arthritis Annals of the Rheumatic Diseases 2018;77:1340
  14. Kirk B, Zanker J, Gustavo Duque G. Osteosarcopenia: epidemiology, diagnosis, and treatment—facts and numbers. Journal of Cachexia. Sarcopenia and Muscle 2020; 11: 609–618.
  15. Sen D, Keen RW. Osteoporosis in systemic lupus erythematosus: prevention and treatment. Lupus. 2001;10(3):227-32. doi: 10.1191/096120301671413439. PMID: 11315358.)
  16. An HJ, Tizaoui K, Terrazzino S, Cargnin S, Lee KH, Nam SW, et al. Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review. Int J Mol Sci. 2020 Aug 7;21(16):5678. doi: 10.3390/ijms21165678
  17. Gordon L. Klein. The effect of glucocorticoids on bone and muscle, Osteoporosis and Sarcopenia, Volume 1, Issue 1, 2015, Pages 39-45, ISSN 2405-5255,
  18. Rinaldi C, Bortoluzzi S, Airoldi C, Leigheb F, Nicolini D, Russotto S, et al. The Early Detection of Osteoporosis in a Cohort of Healthcare Workers: Is There Room for a Screening Program?. Int. J. Environ. Res. Public Health 2021;18:1368.
  19. Perhimpunan Reumatologi Indonesia. Diagnosis dan Pengelolaan Osteoporosis Akibat Glukokortikoid.2021. ISBN 978-979-3730-44-8
  20. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working group on sarcopenia in older people. Age and Ageing 2010;39:412–423.
  21. Cheng KYK, Chow SKH, Hung VWV, Wong CHW, Wong RMY, Tsang CSL, et al. Diagnosis of sarcopenia by evaluating skeletal muscle mass by adjusted bioimpedance analysis validated with dual-energy X-ray absorptiometry. Journal of Cachexia, Sarcopenia and Muscle 2021; 12: 2163–2173.
  22. Kuswardhani RAT. Comprehensive management sarcopenia in elderly. Denpasar: Udayana University press: 2018.
  23. Yoo JI, Ha YC. Review of Epidemiology, Diagnosis, and Treatment of Osteosarcopenia in Korea. J Bone Metab;2018:25:1-7.
  24. Ackermans LLGC, Rabou J, Basrai M, Schweinlin A, Bischoff SC, Cussenot O, et al. Screening, diagnosis and monitoring of sarcopenia: When to use which tool? Clinical Nutrition ESPEN. 2022;48:36–44.
  25. Kambayana G, Sindhughosa DA, Kurniari PK, Gotera W, Kandarini Y. Effect of vitamin D supplementation in disease activity, activity-related markers, inflammatory marker and serum calcium of systemic lupus erythematosus patiens: a systematic review and meta-analysis. Indonesian Journal of Rheumatology. 2021;13(1):504-515.
  26. Hassan EB, Duque G. Osteosarcopenia: A new geriatric syndrome. 2017. Available: publication/320974030.
  27. Cosman F, Beur SJD, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 2014;25:2359–2381.
  28. Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J. Clin. Med;2019:8:488.
  29. Dolan E, Artioli GG, Pereira RMR, Gualano B. Muscular Atrophy and Sarcopenia in the Elderly: Is There a Role for Creatine Supplementation?. Biomolecules;2019:9:642.
  30. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition;2017:14:18.

How to Cite

Tejawati, D. A. K., Gunadi, I. W. H., Kambayana, G., Putrawan, I. B. P., & Kurniari, P. K. (2023). Diagnosis dan penatalaksanaan osteosarkopenia pada penderita sistemik lupus eritematosus. Intisari Sains Medis, 14(2), 434–444.




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Dewa Ayu Kartika Tejawati
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I Wayan Hendra Gunadi
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Gede Kambayana
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Ida Bagus Putu Putrawan
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Pande Ketut Kurniari
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