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Increased prevalence of osteopenia and osteoporosis in systemic sclerosis patients, including in men and young women—a case–control study

Lillpers, Kerstin LU ; Mcguigan, Fiona LU orcid ; Andréasson, Kristofer LU ; Hesselstrand, Roger LU ; C Kapetanovic, Meliha LU and Åkesson, Kristina LU (2024) In Rheumatology (Oxford, England) p.1-9
Abstract
Objectives
To investigate bone mineral density (BMD), osteoporosis prevalence and SSc-specific associations of BMD in SSc patients compared with background population.

Methods
In total, 211 SSc patients (182 women, 29 men; mean age 61.3 and 62.2 years, respectively) and 505 age- and sex-matched controls from the same geographic area participated. BMD and T-score at total hip and lumbar spine was measured by dual-energy X-ray absorptiometry. Osteopenia was defined as T-score –1.0 to –2.5, and osteoporosis as T-score ≤–2.5. Associates of low BMD were identified by multiple regression analysis.

Results
Women with SSc had lower BMD for total hip (P < 0.001) and spine (P = 0.011), equivalent to ΔT-score –0.56... (More)
Objectives
To investigate bone mineral density (BMD), osteoporosis prevalence and SSc-specific associations of BMD in SSc patients compared with background population.

Methods
In total, 211 SSc patients (182 women, 29 men; mean age 61.3 and 62.2 years, respectively) and 505 age- and sex-matched controls from the same geographic area participated. BMD and T-score at total hip and lumbar spine was measured by dual-energy X-ray absorptiometry. Osteopenia was defined as T-score –1.0 to –2.5, and osteoporosis as T-score ≤–2.5. Associates of low BMD were identified by multiple regression analysis.

Results
Women with SSc had lower BMD for total hip (P < 0.001) and spine (P = 0.011), equivalent to ΔT-score –0.56 and –0.35 compared with controls. Osteopenia was present in 51.6% and 16.5% had osteoporosis (P = 0.001, compared with controls). Already in women below age 45 years, differences in hip BMD were apparent (ΔT-score –0.93, P = 0.005). In addition to expected risk factors for osteoporosis (older age, lower BMI and menopause), finger ulcers (P = 0.009) and diffuse skin involvement (P = 0.027) were associated with lower hip BMD in women. In men with SSc, more than half displayed osteopenia or osteoporosis and had numerically lower hip BMD than their age-matched counterparts.

Conclusion
SSc patients, including men and younger women, have lower BMD than the background population. Finger ulcers and diffuse skin involvement, in addition to older age, lower BMI and being post-menopausal, are associated with lower BMD in women. The data emphasize the importance of performing bone health assessment of all SSc patients, including men and young subjects. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Rheumatology (Oxford, England)
article number
keae543
pages
1 - 9
publisher
Oxford University Press
external identifiers
  • pmid:39388250
  • scopus:105004198383
ISSN
1462-0324
DOI
10.1093/rheumatology/keae543
language
English
LU publication?
yes
id
54835a5d-1780-4094-9dc8-97c0bd92ce42
date added to LUP
2025-04-11 10:26:25
date last changed
2025-05-14 04:00:50
@article{54835a5d-1780-4094-9dc8-97c0bd92ce42,
  abstract     = {{Objectives<br/>To investigate bone mineral density (BMD), osteoporosis prevalence and SSc-specific associations of BMD in SSc patients compared with background population.<br/><br/>Methods<br/>In total, 211 SSc patients (182 women, 29 men; mean age 61.3 and 62.2 years, respectively) and 505 age- and sex-matched controls from the same geographic area participated. BMD and T-score at total hip and lumbar spine was measured by dual-energy X-ray absorptiometry. Osteopenia was defined as T-score –1.0 to –2.5, and osteoporosis as T-score ≤–2.5. Associates of low BMD were identified by multiple regression analysis.<br/><br/>Results<br/>Women with SSc had lower BMD for total hip (P &lt; 0.001) and spine (P = 0.011), equivalent to ΔT-score –0.56 and –0.35 compared with controls. Osteopenia was present in 51.6% and 16.5% had osteoporosis (P = 0.001, compared with controls). Already in women below age 45 years, differences in hip BMD were apparent (ΔT-score –0.93, P = 0.005). In addition to expected risk factors for osteoporosis (older age, lower BMI and menopause), finger ulcers (P = 0.009) and diffuse skin involvement (P = 0.027) were associated with lower hip BMD in women. In men with SSc, more than half displayed osteopenia or osteoporosis and had numerically lower hip BMD than their age-matched counterparts.<br/><br/>Conclusion<br/>SSc patients, including men and younger women, have lower BMD than the background population. Finger ulcers and diffuse skin involvement, in addition to older age, lower BMI and being post-menopausal, are associated with lower BMD in women. The data emphasize the importance of performing bone health assessment of all SSc patients, including men and young subjects.}},
  author       = {{Lillpers, Kerstin and Mcguigan, Fiona and Andréasson, Kristofer and Hesselstrand, Roger and C Kapetanovic, Meliha and Åkesson, Kristina}},
  issn         = {{1462-0324}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{1--9}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (Oxford, England)}},
  title        = {{Increased prevalence of osteopenia and osteoporosis in systemic sclerosis patients, including in men and young women—a case–control study}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keae543}},
  doi          = {{10.1093/rheumatology/keae543}},
  year         = {{2024}},
}