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

Abstract

PurposeInvestigate 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).MethodsThirty-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.ResultsIn 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.ConclusionIn 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.

Is osteoporosis an autoimmune mediated disorder?

“…Other autoantibodies linked to bone disease and fragility fractures in existing literature, are anti-nuclear autoantibodies (ANA) and thyroid autoantibodies. Anti centromere and anti topoisomerase 1 (anti SCL70) autoantibodies have been observed to correlate with decreased BMD at various sites ( Marot et al, 2015 , Ibn Yacoub et al, 2012 ). Furthermore, a recent prospective study identified anti double stranded deoxyribonucleic acid (anti dsDNA) as an independent predictor of higher 10 year probability of hip fracture in SLE patients ( Mak et al, 2013 ).…”

Menopause and Rheumatic Disease

“…The presence of ACA was associated with lower bone mineral density in the same study. Digital ulceration was associated with lower total hip and femoral neck bone density 123 . Another study pointed out that earlier onset of menopause in SSc patients is associated with lower bone mineral density 124 .…”

A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease

“…In particular, anti-deoxyribonucleic acid (DNA) topoisomerase I autoantibodies have been noted to significantly correlate with BMD amongst a sample of Moroccan women with systemic sclerosis [ 105 ]. Additionally, anti-centromere autoantibodies have been identified as independent risk factors for bone damage amongst systemic sclerosis patients, whilst high anti-double-stranded DNA (dsDNA) autoantibody levels were observed to independently predict 10-year risk of incurring a hip fracture amongst SLE patients [ 20 , 106 ]. ANAs represent one of the least researched immune markers in relation to pathologic bone loss.…”