Affiliation:
1. V.A. Nasonova Research Institute of Rheumatology
Abstract
Aim of the research – to determine the frequency of osteoporosis (OP) and to identify risk factors for a decrease in bone mineral density (BMD) in postmenopausal women with systemic sclerosis (SSс).Subjects and methods. The study included 113 postmenopausal women (median age – 60.0 [54.0; 63.0] years) with a reliable diagnosis of SSc according to the ACR/EULAR criteria (2013). The exclusion criterion was the presence of overlap syndromes. All women were interviewed according to a unified questionnaire, a laboratory and instrumental examination was conducted, including Dual-energy X-ray absorptiometry.Results. OP and osteopenia in at least one measurement area were diagnosed in 45.1% and 48.7% of women, respectively. Multivariate linear regression analysis revealed a negative effect of the total experience of taking glucocorticoids (GCs) on the value of BMD in the lumbar spine (b=–0.005; R2=0.136; p=0.017). Body mass index (BMI) (b=0.007; R2=0.208; p<0.001), glomerular filtration rate (GFR) (b=0.313; R2=0.213; p<0.001) is positive, and the cumulative dose of GCs (b=–0.269; R2=0.134; p<0.001), the duration of taking proton pump inhibitors (PPI) (b=–0.277; R2=0.291; p<0.001) and the duration of postmenopause (b=–0,223; R2=0.134; p<0.001) negatively affected the BMD of the femoral neck. BMD in the total hip (TH) was generally positively associated with BMI (b=0.493; R2=0.244; p<0.001), GFR (b=0.313; R2=0.150; p<0.001), 25-hydroxy calciferol level (b=0.273; R2=0.284; p=0.001), and negatively – with the cumulative dose of GCs (b=–0.219; R2=0.289; p<0.001).Conclusion. 93.8% of postmenopausal women with SSс had reduced BMD. Of the traditional risk factors, only BMI, the duration of postmenopause and the level of vitamin D had an impact on the state of BMD, and among the specific ones – the cumulative dose and duration of taking GCs, PPI and GFR.
Subject
Immunology,Immunology and Allergy,Rheumatology
Reference26 articles.
1. Nasonov EL (ed.). Rheumatology. Russian clinical recommendations. Moscow:GEOTAR-Media;2017:456 (In Russ.).
2. Zhong L, Pope M, Shen Y, Hernandez JJ, Wu L. Prevalence and incidence of systemic sclerosis: A systematic review and meta-analysis. Int J Rheum Dis. 2019;22(12):2096-2107. doi: 10.1111/1756-185X.13716
3. Alexandersson BT, Geirsson AJ, Olafsson I, Franzson L, Sigurdsson G, Gudbjornsson B. Beina- og kalkbúskapur sjúklinga med herslismein [Bone mineral density and bone turnover in systemic sclerosis]. Laeknabladid. 2007;93(7-8):535-541.
4. Souza RB, Borges CT, Takayama L, Aldrighi JM, Pereira RM. Systemic sclerosis and bone loss: the role of the disease and body composition. Scand J Rheumatol. 2006;35(5):384-387. doi: 10.1080/03009740600704296
5. Serup J, Hagdrup H, Tvedegaard E. Bone mineral content in systemic sclerosis measured by photonabsorptiometry. Acta Derm Venereol. 1983;63(3):235-237.
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