Low Bone Mineral Density and Immunological Insights in Postmenopausal Women Affected by Primary Sjandouml;grenandrsquo;s Syndrome

Abstract

Objective: Osteoporosis is the pathological reduction of bone mineral density (BMD) and the most represented metabolic skeletal disease among population. A reduction in bone mineralization levels is associated with an increased risk of frailty fractures and of healthcare costs. Although there are many evidences bridging rheumatological diseases (such Systemic Sclerosis, Lupus Erythematosus Systemics and Rheumatoid Arthritis) with bone loss, very scarce and contradictory papers evaluate bone health in primary Sjogren's syndrome (pSS). Aim of this retrospective study is to evaluate BMD in pSS and its relationship with inflammatory markers, Ro/SSA and La/SSB antibodies. Methods: Fifty-three postmenopausal pSS were matched with 93 controls and studied for BMD measured by Dual Energy X- ray absorptiometry (DXA). Anti-nuclear antibodies (ANA), anti-extractable nuclear antigens (ENA), Anti- Ro/SSA, and anti-La/SSB antibodies, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected too. Mean BMDs of each explored region was compared and osteoporosis’s (OP) prevalence was assessed. Pearson’s analysis and multivariate regression models were built to highlight variables interrelations. Results: BMD was lower in pSS compared to controls, both expressed as g/cm2 and T-score considering lumbar spine and femoral neck. OP prevalence was higher among pSS compared to controls. Weight acted as the best predictor of lumbar BMD in multivariate model. No difference on BMD status was found between pSS with antibodies positivity and altered inflammatory markers with subjects displaying normal sera levels of the abovementioned variables. Conclusions: pSS female patients in an early stage of disease have lower BMD compared to healthy controls. Anti- Ro/SSA and anti/La antibodies and inflammatory markers are not related with BMD.