Psoriasis and bone mineral density: Implications for long‐term patients

Abstract

Psoriasis is a chronic inflammatory disease associated with several comorbidities. Osteoporosis is defined as a reduction in bone mineral density with impaired bone microarchitecture. Several mechanisms may be implicated as a possible cause for the association between psoriasis and osteoporosis, such as systemic inflammation, anti-psoriatic drug intake and joint dysfunction for psoriatic arthritis (PsA). The aim of the present study was to assess bone mineral density (BMD) in patients with psoriasis, correlating the prevalence of osteopenia/osteoporosis with Psoriasis Area and Severity Index (PASI) score, mean duration of psoriatic disease, PsA and previous treatments for psoriasis. Forty-three consecutive patients with psoriasis, 19 of whom were affected by the arthropathic form, were enrolled. We evaluated the severity of psoriasis as measured by PASI score, the CASPAR criteria and ultrasounds of the joints to verify the diagnosis of PsA and the age of psoriasis onset to estimate mean disease duration. Patients underwent a bone density scan of the lumbar spine and femoral neck by dual-energy X-ray absorptiometry to measure BMD. Patients with osteopenia/osteoporosis showed a statistically significant longer average duration of psoriatic disease (17 years), compared to patients affected by psoriasis with normal T-score (8.8 years) (P = 0.04). The linear logistic regression confirms a significant relation between mean psoriatic disease duration and BMD alterations (P = 0.04). Our results suggest the necessity of an early diagnostic evaluation of bone metabolism in patients with psoriasis, especially if characterized by longer disease duration.

Close correlation of bone mineral density and body mass index in Japanese psoriasis patients

“…1c). 1 The duration of psoriasis is longer in patients with BML than those with normal BMD, but it may reflect the difference of mean age (Fig. 1d).…”

“…Bone mineral loss (BML) can also be correlated with the severity or duration of psoriasis in non-Asian populations. 1 We analyzed femoral bone mineral density (BMD) of Japanese psoriasis patients, focusing on subtypes and duration of psoriasis, and body mass index (BMI). Femoral BMD reflecting systemic BMD was measured by dual-energy X-ray absorptiometric scanning in a total of 57 cases of psoriasis at the Department of Dermatology, Asahikawa Medical University Hospital.…”

Systemic Osteoporosis and Psoriatic Arthritis: Current Understanding of the Problem

“…Авторы не выявили связи между частотой снижения МПК и наличием ПсА, но была об-наружена статистически достоверная ассоциация с об-щей длительностью псориатического процесса. В заклю-чение авторы указали на необходимость ранней диагно-стики нарушений костного обмена и состояния МПК, а также профилактического назначения противоостео-поротических препаратов при длительном течении псо-риаза и ПсА [7]. L.C.…”

“…Исследование итальянских авторов продемонстри-ровало отсутствие связи между наличием ОП или остеопе-нии у больных ПсА и псориазом и терапией метотрексатом (МТ), инфликсимабом, этанерцептом и адалимумабом. В то же время 16% пациентов со сниженной МПК получа-ли циклоспорин А [7].…”

“…[7], в которой было установлено, что 30% пациентов с псо-риазом или ПсА и низкой МПК имели дефицит витами-на D, а среди больных с нормальной МПК его частота составляла лишь 7%. В исследовании турецких авторов [22] было обнаружено, что пациенты с ПсА и деформа-циями позвонков имели более высокий уровень витами-на D (25(ОН)D) в крови по сравнению с лицами без пе-реломов, хотя и у тех, и у других его средний уровень со-ответствовал дефициту и был достоверно ниже, чем в контроле.…”