Bone mineral density in patients with systemic sclerosis and its association with hand involvement

Abstract

Aim of the workThe aim of the present study is to assess bone mineral density (BMD) in systemic sclerosis (SSc) patients and to determine associated factors. Patients and methodsSixty-five female SSc patients (mean age 39.5±13.5years, disease duration 7.3±5.9years), and forty age- and sex- matched controls were included. Forty-seven patients had limited SSc and 18 had diffuse type. Patients were subjected to clinical and functional assessment. BMD was quantified at the distal radius, femoral neck and lumbar spine (L2–4) by dual energy X-ray absorptiometry. ResultsSSc patients had a higher frequency of osteoporosis at the distal radius and osteopenia at the lumbar spine (p=0.001 and 0.002, respectively), but the BMD at the femoral neck was not significantly different from the control group. Patients with osteoporosis at the distal radius had a significantly higher frequency of hand deformities (p<0.05) and higher functional scores reflecting more disability than patients without (p=0.01), while patients with osteoporosis at the lumbar spine were significantly older (p<0.001) and had a longer disease duration than those without (p=0.001). No associations were found between menopausal status, SSc subtype, skin score, internal organ affection and osteoporosis at the three skeletal sites. ConclusionPatients with SSc have lower bone mineral density than controls at the distal radius and lumbar spine. Osteoporosis at the distal radius is associated with the presence of hand deformity and functional disability, while osteoporosis at the lumbar spine is associated with older age and longer disease duration.