Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Elevated pro-BNP and low-grade inflammation are associated with low bone mineral density in systemic sclerosis, a case control study

Lillpers, Kerstin LU ; Andréasson, Kristofer LU ; Najibi, Seyed Morteza LU orcid ; Woolf, Anthony D LU ; Hesselstrand, Roger LU ; Åkesson, Kristina E LU and Kapetanovic, Meliha C LU (2026) In Arthritis Research & Therapy 28(1).
Abstract

BACKGROUND: Bone mineral density (BMD) is compromised in patients with systemic sclerosis (SSc) compared to the background population, yet the underlying disease related factors are less known. This study evaluates SSc disease-related features and predictability for BMD along with established risk factors for low BMD in SSc patients compared to controls.

METHODS: The study includes 211 SSc patients, 182 women and 29 men (mean age 61 yrs, mean disease duration 9 yrs) regularly followed at the Skåne University Hospital, Lund, Sweden and 505 age- and sex-matched controls.

DATA COLLECTION: BMD hip and spine, BMI, SSc-features, biomarkers and potential risk factor questionnaire. Multinomial logistic regression analysis was used... (More)

BACKGROUND: Bone mineral density (BMD) is compromised in patients with systemic sclerosis (SSc) compared to the background population, yet the underlying disease related factors are less known. This study evaluates SSc disease-related features and predictability for BMD along with established risk factors for low BMD in SSc patients compared to controls.

METHODS: The study includes 211 SSc patients, 182 women and 29 men (mean age 61 yrs, mean disease duration 9 yrs) regularly followed at the Skåne University Hospital, Lund, Sweden and 505 age- and sex-matched controls.

DATA COLLECTION: BMD hip and spine, BMI, SSc-features, biomarkers and potential risk factor questionnaire. Multinomial logistic regression analysis was used to calculate BMD odds ratio (OR); multiple linear regression for associations between T-score and SSc-related variables and lifestyle factors; and machine learning to fit a model to predict total hip T-score in SSc.

RESULTS: NT-proBNP and elevated CRP were independently associated with low BMD in SSc patients (p<0.001), as were diffuse cutaneous disease subtype, finger ulcers, vital lung capacity and anti-topoisomerase I antibodies (ATA). BMI, menopausal status, low physical activity and higher medication burden were associated with lower hip T-score. Predictive modeling identified BMI and NT-proBNP as the strongest determinants of hip T-score.

CONCLUSION: This large case-control study finds elevated NT-proBNP, indicators of low-grade inflammation and of disease severity negatively associated with BMD in SSc patients, in addition to several established risk factors. This highlights the importance of BMD assessment to identify at-risk SSc patients beyond traditional risk stratification.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Female, Scleroderma, Systemic/blood, Middle Aged, Male, Bone Density/physiology, Case-Control Studies, Aged, Inflammation/blood, Biomarkers/blood, Risk Factors, Peptide Fragments/blood, Osteoporosis
in
Arthritis Research & Therapy
volume
28
issue
1
article number
160
publisher
BioMed Central (BMC)
external identifiers
  • pmid:42675495
  • scopus:105048899720
ISSN
1478-6354
DOI
10.1186/s13075-026-03888-6
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
d0cdefc3-f7b0-4701-9820-9be4a932911f
date added to LUP
2026-09-21 10:09:56
date last changed
2026-09-22 04:17:21
@article{d0cdefc3-f7b0-4701-9820-9be4a932911f,
  abstract     = {{<p>BACKGROUND: Bone mineral density (BMD) is compromised in patients with systemic sclerosis (SSc) compared to the background population, yet the underlying disease related factors are less known. This study evaluates SSc disease-related features and predictability for BMD along with established risk factors for low BMD in SSc patients compared to controls.</p><p>METHODS: The study includes 211 SSc patients, 182 women and 29 men (mean age 61 yrs, mean disease duration 9 yrs) regularly followed at the Skåne University Hospital, Lund, Sweden and 505 age- and sex-matched controls.</p><p>DATA COLLECTION: BMD hip and spine, BMI, SSc-features, biomarkers and potential risk factor questionnaire. Multinomial logistic regression analysis was used to calculate BMD odds ratio (OR); multiple linear regression for associations between T-score and SSc-related variables and lifestyle factors; and machine learning to fit a model to predict total hip T-score in SSc.</p><p>RESULTS: NT-proBNP and elevated CRP were independently associated with low BMD in SSc patients (p&lt;0.001), as were diffuse cutaneous disease subtype, finger ulcers, vital lung capacity and anti-topoisomerase I antibodies (ATA). BMI, menopausal status, low physical activity and higher medication burden were associated with lower hip T-score. Predictive modeling identified BMI and NT-proBNP as the strongest determinants of hip T-score.</p><p>CONCLUSION: This large case-control study finds elevated NT-proBNP, indicators of low-grade inflammation and of disease severity negatively associated with BMD in SSc patients, in addition to several established risk factors. This highlights the importance of BMD assessment to identify at-risk SSc patients beyond traditional risk stratification.</p>}},
  author       = {{Lillpers, Kerstin and Andréasson, Kristofer and Najibi, Seyed Morteza and Woolf, Anthony D and Hesselstrand, Roger and Åkesson, Kristina E and Kapetanovic, Meliha C}},
  issn         = {{1478-6354}},
  keywords     = {{Humans; Female; Scleroderma, Systemic/blood; Middle Aged; Male; Bone Density/physiology; Case-Control Studies; Aged; Inflammation/blood; Biomarkers/blood; Risk Factors; Peptide Fragments/blood; Osteoporosis}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Arthritis Research & Therapy}},
  title        = {{Elevated pro-BNP and low-grade inflammation are associated with low bone mineral density in systemic sclerosis, a case control study}},
  url          = {{http://dx.doi.org/10.1186/s13075-026-03888-6}},
  doi          = {{10.1186/s13075-026-03888-6}},
  volume       = {{28}},
  year         = {{2026}},
}