Bone mineral density and body composition in postmenopausal women with psoriasis and psoriatic arthritis

Abstract

IntroductionThe aim of the present study was to compare bone mineral density (BMD) and body composition (BC) measurements as well as identify risk factors for low BMD and osteoporotic fractures in postmenopausal women with psoriasis (Ps) and psoriatic arthritis (PsA).MethodsA cross-sectional study was carried out in 45 PsA women, 52 Ps women and 98 healthy female controls (HC). Clinical risk factors for low bone density and osteoporotic fracture were evaluated by a specific questionnaire. An X-ray absorptiometry (DXA) at the lumbar spine, total femur and total body was performed on all patients. Skin and joint outcomes were measured by specific tools (PASI, HAQ and DAS28). Morphometric vertebral fractures were evaluated by lumbar and thoracic spine X-ray, according to Genant's method.ResultsThere were no significant differences in age, body mass index (BMI), total lean mass and bone mineral density among the groups. However, the PsA group had a significantly higher body fat percentage (BF%) than the Ps and HC groups. Osteoporotic fractures were more frequently observed in PsA and Ps groups than in the HC group (P = 0.01). Recurrent falls and a longer duration of disease increased the risk of fracture (odds ratio (OR) = 18.3 and 1.08, respectively) in the PsA group (P = 0.02). Disability was the main factor related to osteoporotic fracture in the Ps group (odds ratio (OR) = 11.1) (P = 0.02).ConclusionsPs and PsA patients did not present lower BMD. However, they had a higher prevalence of osteoporotic fractures and higher risk of metabolic syndrome. Patients with a longer duration of disease, disability and recurrent falls need preventive measures.

Osteoporosis in psoriatic arthritis: Is there any?

“…In their study of comparing patients with psoriasis and patients who also had psoriatic arthritis Borman et al did not find any significant difference in BMD [29]. In the most recent study Pedreira et al analyzed bone density separately in postmenopausal women with psoriasis, PsA and in controls and found no significant differences between those groups, too [30].…”

UVB and Vitamin D in Psoriasis

“…The existence of less severe periarticular osteoporosis has also been reported (105). Psoriasis patients with peripheral arthritis with longer duration of joint disease (106) and patients with a greater number of affected joints are at a higher risk of developing osteoporosis (102).In a study by Pedreira, patients with psoriasis and psoriatic arthritis did not present with a lower BMD, but they had a higher prevalence of osteoporotic fractures and were at a higher risk of developing metabolic syndrome (107).…”

Psoriasis and osteoporosis

“…Wykazano również dodatnią korelację między stężeniem TNF-α w surowicy a wskaźnikiem PASI (psoriasis area severity index) [7]. Zwrócono uwagę, że TNF-α może pobudzać rozwój osteoklastów, przez co nasila resorpcję kości [8][9][10]. Co więcej, u chorych z łusz-czycowym zapaleniem stawów stwierdzono, że zastosowanie inhibitorów TNF-α spowodowało zmniejszenie wytwarzania osteoklastów [10].…”

“…Zwrócono uwagę, że TNF-α może pobudzać rozwój osteoklastów, przez co nasila resorpcję kości [8][9][10]. Co więcej, u chorych z łusz-czycowym zapaleniem stawów stwierdzono, że zastosowanie inhibitorów TNF-α spowodowało zmniejszenie wytwarzania osteoklastów [10]. Innym czynnikiem pobudzającym resorpcję kości jest interleukina 6 (IL-6) [8].…”