Prevalence and predictive factors of osteoporosis in systemic sclerosis patients: a case-control study.

Mathilde Marot,Eric Esteve,Antoine Valéry,Guido Bens,Adelheid Müller,Eric Lespessailles,Hechmi Toumi,Stéphanie Rist

doi:10.18632/oncotarget.3806

Abstract

Investigate the prevalence of osteoporosis in patients with systemic sclerosis (SSc) and describe alterations of bone tissue with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT). Thirty-three patients and 33 controls matched on age, body mass index (BMI) and menopause were included. Bone mineral density (BMD) was measured at the lumbar spine (LS), femoral neck (FN) and total hip (TH) by dual energy X-ray absorptiometry. Volumetric BMD (vBMD) and bone microarchitecture were measured by HR-pQCT at tibia and radius. In patients, BMI was significantly lower, the prevalence of osteoporosis was significantly higher and HR-pQCT analysis showed a significant alteration of the trabecular compartment with a decrease in trabecular vBMD on both sites than in controls. In multivariate analysis, a low lean body mass, presence of anticentromere antibodies and older age were identified as independent factors for decreased BMD at LS (r²=0.43), FN (r²=0.61) and TH (r²=0.73). History or current digital ulcers were also identified as an independent factor for microarchitecture alteration. In patients an increased prevalence of osteoporosis was found and HR-pQCT showed impaired trabecular bone compartment. Also, low lean body mass, high age, digital ulcers and ACAs were identified as independent risk factors for bone damage.

Highlights

Systemic sclerosis (SSc) is a chronic connective tissue disease characterized both by fibrosis and endothelial dysfunction [1]. the extent of skin involvement is the key feature of this common disease, joint, periarticular soft tissue and bone may be involved, leading to severe alteration of the quality of life [2] in particular when hands and feet are affected by the disease [3]
The extent of skin involvement is the key feature of this common disease, joint, periarticular soft tissue and bone may be involved, leading to severe alteration of the quality of life [2] in particular when hands and feet are affected by the disease [3]
OP is characterized by low bone mass and by bone quality alterations both leading to aincreased risk of fracture

Summary

Introduction

Systemic sclerosis (SSc) is a chronic connective tissue disease characterized both by fibrosis and endothelial dysfunction [1]. the extent of skin involvement is the key feature of this common disease, joint, periarticular soft tissue and bone may be involved, leading to severe alteration of the quality of life [2] in particular when hands and feet are affected by the disease [3]. Chronic inflammatory rheumatic diseases like rheumatoid arthritis and spondyloarthropathy are well recognized risk factors of bone loss and fractures [5]. SSc has been recognized to be another potential inflammatory joint diseases that may affect bone tissue [6,7,8]. High-Resolution www.impactjournals.com/oncotarget peripheral Quantitative Computed Tomography (HRpQCT) is a non-invasive imaging technique that can measure volumetric BMD (vBMD) and microarchitecture parameters of cortical and trabecular bone [10]. This tool has been used in clinical studies to investigate differences in bone microarchitecture between patients with or without fractures [11, 12]. We described the existence of qualitative disorders of bone tissue in SSc by HR-pQCT and further investigated the associations of some illness’s characteristics with bone parameters

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