Complex assessment of bone mineral density, fracture risk, vitamin D status, and bone metabolism in Hungarian systemic sclerosis patients

Ágnes Horváth, Edit Végh, Anita Pusztai, Zsófia Petho, Attila Hamar, Monika Czókolyová, Harjit Pal Bhattoa, Gábor Nagy, Balázs Juhász, Katalin Hodosi, Andrea Domján, Zoltán Szekanecz, Gabriella Szücs, Szilvia Szamosi

Research output: Contribution to journalArticle

Abstract

Objective: We wished to determine bone alterations in systemic sclerosis (SSc) patients by conventional densitometry (DXA), peripheral quantitative computed tomography (pQCT), and bone biomarkers. Methods: We included 44 SSc patients and 33 age-matched healthy controls. Lumbar spine and femoral neck bone mineral density (BMD) was assessed by DXA. Volumetric BMD was measured by pQCT at the radius. FRAX, 25-hydroxyvitamin-D3 (25-OH-D3), parathyroid hormone, osteocalcin, C-terminal collagen telopeptide, and procollagen type I amino-terminal propeptide were also assessed. Results: SSc patients had lower L2-4 BMD (0.880 ± 0.108 vs. 0.996 ± 0.181 g/cm2; p = 0.019) and femoral neck (FN) BMD (0.786 ± 0.134 vs. 0.910 ± 0.090 g/cm2; p = 0.007) by DXA. In SSc vs. controls, pQCT indicated lower mean cortical (328.03 ± 103.32 vs. 487.06 ± 42.45 mg/cm3; p < 0.001) and trabecular density (150.93 ± 61.91 vs. 184.76 ± 33.03 mg/cm3; p = 0.037). Vitamin D3 deficiency was more common in SSc vs. controls (60.0% vs. 39.3%; p = 0.003). L2-4 (p = 0.002) and FN BMD (p = 0.015) positively correlated with BMI. pQCT assessments confirmed an inverse correlation between pulmonary manifestation and total (p = 0.024), trabecular (p = 0.035), and cortical density (p = 0.015). Anti-Scl70 positivity inversely correlated with pQCT total density (p = 0.015) and the presence of digital ulcers with cortical density (p = 0.001). We also found that vertebral and FN BMD as determined by DXA significantly correlated with pQCT total, trabecular, and cortical density (p < 0.05). Conclusion: The results of our study suggest that bone loss in SSc patients may be associated with lower BMI, anti-Scl70 positivity, and the presence of pulmonary manifestations and digital ulcers. Both DXA and pQCT are appropriate tools to evaluate the bone alterations in SSc patients.

Original languageEnglish
Article number274
JournalArthritis Research and Therapy
Volume21
Issue number1
DOIs
Publication statusPublished - Dec 10 2019

Keywords

  • Bone loss
  • DXA
  • Osteoporosis
  • Pulmonary manifestations
  • Scl70
  • Systemic sclerosis
  • pQCT

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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    Horváth, Á., Végh, E., Pusztai, A., Petho, Z., Hamar, A., Czókolyová, M., Bhattoa, H. P., Nagy, G., Juhász, B., Hodosi, K., Domján, A., Szekanecz, Z., Szücs, G., & Szamosi, S. (2019). Complex assessment of bone mineral density, fracture risk, vitamin D status, and bone metabolism in Hungarian systemic sclerosis patients. Arthritis Research and Therapy, 21(1), [274]. https://doi.org/10.1186/s13075-019-2072-y