Men, younger women with systemic sclerosis have lower bone mineral density vs controls
Click Here to Manage Email Alerts
Key takeaways:
- Bone mineral density was lower in both men and women younger than 45 years with SSc vs. matched controls.
- Risk factors for women included finger ulcers and diffuse skin involvement.
Patients with systemic sclerosis demonstrate lower bone mineral density compared with the general population, with significant differences reported in women aged younger than 45 years, according to data published in Rheumatology.
“Established risk factors for osteoporosis include older age, smoking, low BMI and malnutrition, low physical activity, systemic inflammation, use of corticosteroids and family prevalence of osteoporosis,” Kerstin Lillpers, MD, a PhD student at Skåne University Hospital, in Sweden, and colleagues wrote. “Several of these potential risk factors are common in patients with SSc. However, the studies investigating bone health in SSc are still limited.”
To analyze bone mineral density and osteoporosis in patients with SSc vs. the general population, Lillpers and colleagues conducted a case-control study of adults with SSc treated at Skåne University Hospital between August 2016 and December 2017. The study included 211 patients with SSc (86.3% women) and, for each participant, five age- and sex-matched controls from the same geographic area, identified via the Swedish population register.
Dual energy X-ray absorptiometry was used to assess bone mineral density, both in terms of g/cm2 and T-score, at the lumbar spine, femoral neck and total hip. Associations between bone mineral density and patient characteristics were assessed using multiple linear regression.
According to the researchers, bone mineral density among women with SSc was lower at all sites compared with controls, especially at the femoral neck, where it was 9.2% lower. Meanwhile, women aged younger than 45 years demonstrated “large differences” in bone mineral density vs. the general population, including a mean T-score difference of –0.93 (95% CI, –1.56 to –0.30) at the hip, the researchers wrote. Risk factors for lower hip bone mineral density among women included finger ulcers (P = .009) and diffuse skin involvement (P = .027).
Men with SSc tended to have lower bone mineral density at the hip (mean T-score difference = –0.37; 95% CI, –0.75 to –0.02) and femoral neck (mean T-score difference = –0.41; 95% CI, –0.85 to 0.03) than age-matched controls, but not to a statistically significant degree, the researchers wrote. More than half of men with SSc demonstrated low bone mineral density, but only one male participant had osteoporosis.
“This large, single-center, case-control study demonstrates that SSc patients, even younger women, have lower BMD compared to the background population,” Lillpers and colleagues wrote. “For women, finger ulcers and [diffuse cutaneous SSc] are additional disease-specific factors associated with lower BMD. A similar tendency toward low BMD was also observed in men. These findings emphasize the importance of performing regular bone health assessments in all patients, both women and men and at all ages, even early after diagnosis.”
Collapse
Read more about
Click Here to Manage Email Alerts