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The frequency and risk factors of low bone mineral density in patients with systemic sclerosis
https://doi.org/10.33667/2078-5631-2025-9-23-27
Abstract
Objective. To study the frequency of low bone mineral density (BMD) and BMD-related factors in patients with systemic sclerosis (SSc).
Material and Methods. 210 patients with SSc (median age 52,0 [41,3; 62,1] years) were included: 165 (78,6 %) women and 45 (21,4 %) men. BMD was measured by DXA. In postmenopausal women and men ≥ 50 years OP was diagnosed with T-score at any region < –2.5 SD, in fertile women and men under 50 years of age low BMD was detected with – Z-score <-2.0 SD. To identify the factors associated with low BMD, a logistic regression analysis was performed.
Results. Low BMD was detected in 63 (30,0 %) persons. Multivariate analysis showed association between low BMD and age (OR 1,03; [95 % CI 1,01; 1,07]; р<0,05), body mass index (BMI) ≤24 kg/m2 (OR 3,81; [95 % CI 1,76; 8,07]; p < 0.001), acroosteolysis (AO) of distal phalanges (OR 4,56; [95 % CI 1,29; 16,17]; р<0,05), duration of glucocorticoids (GСs) taking (OR1,07; [95% CI 1,01; 1,14]; р<0,05) and anti-topoisomerase I positivity (OR 2,07; [95% CI 1,06; 4,16]; р<0,05).
Conclusion. Low BMD was detected in 63 (30,0 %) persons. Age, BMI ≤24 kg/m2, AO of distal phalanges, duration of GСs taking and antitopoisomerase I positivity increased the risk of OP/low BMD in patients with SSc.
Supporting agencies: The study was conducted within the framework of scientific topic No. РК 125020501433–4 and was approved by the local ethics committee of the V.A. Nasonova Research Institute of Rheumatology.
About the Authors
A. O. Sorokina
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Arina O. Sorokina - MD, junior researcher at Osteoporosis Dept.
Moscow
O. V. Dobrovolskaya
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Olga V. Dobrovolskaya - PhD Med, researcher at Osteoporosis Dept.
Moscow
N. V. Toroptsova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Natalia V. Toroptsova - DM Sci (habil.), head of Osteoporosis Dept.
Moscow
References
1. NIH Consensus Development Conference on Osteoporosis: Prevention, Diagnosis and Therapy. JAMA. 2000; 287: 785–95.
2. Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R; National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014 Oct; 25 (10): 2359–81. DOI: 10.1007/s00198-014-2794-2. Epub 2014 Aug 15. Erratum in: Osteoporos Int. 2015 Jul; 26 (7): 2045–7. DOI: 10.1007/s00198-015-3037-x. PMID: 25182228; PMCID: PMC 4176573.
3. Gabrielli A, Avvedimento EV, Krieg T. Scleroderma. N Engl J Med. 2009 May 7; 360 (19): 1989–2003. DOI: 10.1056/NEJMra0806188. PMID: 19420368.
4. Binder E. F. (2008 Jun), Kiel D. P. (2008) Genetics of the musculoskeletal system: a pleiotropic approach. J Bone Miner Res. 23 (6): 788–802. https://doi.org/10.1359/jbmr.080218
5. Omair MA, Pagnoux C, McDonald-Blumer H, Johnson SR. Low bone density in systemic sclerosis. A systematic review. J Rheumatol. 2013 Nov; 40 (11): 1881–90. DOI: 10.3899/jrheum.130032. Epub 2013 Sep 15. PMID: 24037552.
6. Avouac J., Koumakis E., Toth E., Meunier M., Maury E., Kahan A., Cormier C., Allanore Y., Arthritis Care Res (Hoboken), Increased Risk of Osteoporosis and Fracture in Women with Systemic Sclerosis: A Comparative Study with Rheumatoid Arthritis Ю, Arthritis Care & Research. 2012 Dec; 64 (12): 1871–1878. DOI: 10.1002/acr.21761
7. Marighela T. F., Genaro Pde S., Pinheiro M. M., Szejnfeld V. L., Kayser C. Risk factors for body composition abnormalities in systemic sclerosis. Clin Rheumatol. 2013; 32 (7): 1037–1044. DOI: 10.1007/s10067-013-2235-1
8. Corrado A., Colia R., Mele A. et al. Relationship between Body Mass Composition, Bone Mineral Density, Skin Fibrosis and 25(OH) Vitamin D Serum Levels in Systemic Sclerosis [published correction appears in PLoS One. 2015; 10 (11): e0142748]. PLoS One. 2015; 10 (9): e0137912. Published 2015 Sep 16. DOI: 10.1371/journal.pone.0137912
9. Marot M., Valéry A., Esteve E. et al. Prevalence and predictive factors of osteoporosis in systemic sclerosis patients: a case-control study. Oncotarget. 2015; 6 (17): 14865–14873. DOI: 10.18632/oncotarget.3806
10. Caimmi C., Caramaschi P., Barausse G. et al. Bone Metabolism in a Large Cohort of Patients with Systemic Sclerosis. Calcif Tissue Int. 2016; 99 (1): 23–29. DOI: 10.1007/s00223-016-0119-5
11. Thietart S., Louati K., Gatfosse M. et al. Overview of osteo-articular involvement in systemic sclerosis: Specific risk factors, clinico-sonographic evaluation, and comparison with healthy women from the French OFELY cohort. Best Pract Res Clin Rheumatol. 2018; 32 (4): 591–604. DOI: 10.1016/j.berh.2019.01.008
12. Paolino S., Gotelli E., Goegan F. et al. Body composition and bone status in relation to microvascular damage in systemic sclerosis patients. J Endocrinol Invest. 2021; 44 (2): 255–264. DOI: 10.1007/s40618-020-01234-4
13. Chuealee W., Foocharoen C., Mahakkanukrauh A., Suwannaroj S., Pongchaiyakul C., Nanagara R. Prevalence and predictive factors of osteoporosis in Thai systemic sclerosis. Sci Rep. 2021; 11 (1): 9424. Published 2021 May 3. DOI: 10.1038/s41598-021-88792-6
14. Cantero-Nieto L., Álvarez-Cienfuegos A., García-Gómez J.A., Ríos-Fernández R., Robledo G., Ortego-Centeno N. Association between FGF-23 levels and risk of fracture in women with systemic sclerosis. J Clin Densitom. 2021; 24 (3): 362–368. DOI: 10.1016/j.jocd.2020.05.010
15. Bimal G., Sahhar J., Savanur M., Ngian G. S. Screening rates and prevalence of osteoporosis in a real-world, Australian systemic sclerosis cohort. Int J Rheum Dis. 2022; 25 (2): 175–181. DOI: 10.1111/1756-185X.14254
16. Ivanova Yu. Yu., Bugrova O. V., Belyaeva O. N., Polishchuk I. S., Sayfutdinov R. I., Shaveleva L. A. Some risk factors for osteoporosis in patients with systemic sclerosis. Orenburg medical herald. Book X. 2022; 3 (39): 29–32.
17. Tu X., Li C., Zhuang M., Liu L., Xu C., Wang J. High prevalence and risk factors for osteoporosis in 1839 patients with systemic sclerosis: a systematic review and meta-analysis. Clin Rheumatol. 2023; 42 (4): 1087–1099. DOI: 10.1007/s10067-022-06460-0
18. Mok C. C., Chan P. T., Chan K. L., Ma K. M. Prevalence and risk factors of low bone mineral density in Chinese patients with systemic sclerosis: a case-control study. Rheumatology (Oxford). 2013; 52 (2): 296–303. DOI: 10.1093/rheumatology/kes240
19. Midol C., Wiebe E., Siegert E. et al. Risk of Osteoporosis in Patients with Systemic Sclerosis: A Cross-Sectional Analysis of Two European Prospective Cohorts [abstract]. Arthritis Rheumatol. 2021; 73 (suppl. 10).
20. Ibn Yacoub Y., Amine B., Laatiris A., Wafki F., Znat F., Hajjaj-Hassouni N. Bone density in Moroccan women with systemic scleroderma and its relationships with disease-related parameters and vitamin D status. Rheumatol Int. 2012; 32 (10): 3143–3148. DOI: 10.1007/s00296-011-2150-1
21. Loucks J, Pope JE. Osteoporosis in scleroderma. Semin Arthritis Rheum. 2005 Feb; 34 (4): 678–82. DOI: 10.1016/j.semarthrit.2004.08.006. PMID: 15692961.
22. Taylan A., Birlik M., Kenar G. et al. Osteoprotegrin interacts with biomarkers and cytokines that have roles in osteoporosis, skin fibrosis, and vasculopathy in systemic sclerosis: A potential multifaceted relationship between OPG/ RANKL/TRAIL and Wnt inhibitors. Mod Rheumatol. 2019; 29 (4): 619–624. DOI: 10.1080/14397595.2018.1500736
23. Midol C., Wiebe E., Siegert E. et al. Osteoporosis is associated with anti-topoisomerase I positivity and glucocorticoids use in patients with systemic sclerosis. Rheumatology (Oxford). Published online March 7, 2024. DOI: 10.1093/rheumatology/keae142
24. Lescoat A., Leroy M., Coiffier G. et al. Bone mineral density and trabecular bone score assessment in systemic sclerosis: A cross-sectional study. Joint Bone Spine. 2021; 88 (5): 105214. DOI: 10.1016/j.jbspin.2021.105214
25. Midol C., Wiebe E., Siegert E. et al. Risk of Osteoporosis in Patients with Systemic Sclerosis: A Cross-Sectional Analysis of Two European Prospective Cohorts [abstract]. Arthritis Rheumatol. 2021; 73 (suppl. 10).
26. Jamal SA, Swan VJ, Brown JP. et al. Kidney function and rate of bone loss at the hip and spine: the Canadian Multicentre Osteoporosis Study [retracted in: Am J Kidney Dis. 2016 Aug;68(2):333]. Am J Kidney Dis. 2010; 55 (2): 291–299. DOI: 10.1053/j.ajkd.2009.10.049
27. Klawansky S, Komaroff E, Cavanaugh PF Jr. et al. Relationship between age, renal function and bone mineral density in the US population. Osteoporos Int. 2003; 14 (7): 570–576. DOI: 10.1007/s00198-003-1435-y
Review
For citations:
Sorokina A.O., Dobrovolskaya O.V., Toroptsova N.V. The frequency and risk factors of low bone mineral density in patients with systemic sclerosis. Medical alphabet. 2025;(9):23-27. (In Russ.) https://doi.org/10.33667/2078-5631-2025-9-23-27
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