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Systemic Sclerosis
Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study with rheumatoid arthritis
Article first published online: 28 NOV 2012
DOI: 10.1002/acr.21761
Copyright © 2012 by the American College of Rheumatology
Additional Information
How to Cite
Avouac, J., Koumakis, E., Toth, E., Meunier, M., Maury, E., Kahan, A., Cormier, C. and Allanore, Y. (2012), Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study with rheumatoid arthritis. Arthritis Care Res, 64: 1871–1878. doi: 10.1002/acr.21761
Publication History
- Issue published online: 28 NOV 2012
- Article first published online: 28 NOV 2012
- Accepted manuscript online: 21 JUN 2012 09:14AM EST
- Manuscript Accepted: 7 JUN 2012
- Manuscript Received: 23 JAN 2012
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Abstract
Objective
To investigate whether women with systemic sclerosis (SSc) have an increased risk of osteoporosis (OP) and related fractures compared to a high-risk population with rheumatoid arthritis (RA) and also healthy controls, and to determine putative specific OP and fracture risk factors.
Methods
We performed a cross-sectional study with successive inclusion of age-matched healthy women and women with SSc and RA. Risk factors for OP and fracture were collected for all patients. Bone mineral density (BMD) was systematically measured at the lumbar spine and total hip region with dual x-ray absorptiometry.
Results
We included 71 women with SSc, 139 women with RA, and 227 healthy women. The prevalence of OP and fracture was similar in SSc and RA, and was for both diseases higher than in healthy controls (OP: 30% in SSc, 32% in RA, and 11% in controls; fracture: 35% in SSc, 33% in RA, and 10% in controls). Multivariate analysis identified age as a risk factor of OP in SSc. Age and low 25-hydroxyvitamin D (25[OH]D) levels were recognized as risk factors of fracture in SSc. In comparison, age and corticosteroid treatment were associated with OP in RA. Multivariate analysis confirmed age, OP, and low 25(OH)D levels as independent risk factors of fractures in RA.
Conclusion
The prevalence of OP and fracture in SSc was increased compared to healthy women and reached the high prevalence associated with RA. Age and vitamin D deficiency were identified as risk factors of fracture in SSc. Therefore, increasing the awareness and performance of BMD measurements together with the vitamin D supply in patients with SSc is warranted.