Increased risk for bone loss in women with systemic sclerosis: a comparative study with rheumatoid arthritis

Aim To assess bone mass in women with systemic sclerosis ( SS c) in comparison to age and sex‐matched patients with rheumatoid arthritis ( RA ), and to evaluate factors influencing bone mineral density ( BMD ). Methods Patients were consecutively recruited and assessed for BMD at the lumbar spine and hip by dual‐energy X ‐ray absorptiometry ( DEXA ) using a densitometer. In SS c, the extent of skin involvement, modified R odnan skin thickness score (m RSS ) and M edsger disease severity index were assessed. Results Forty‐three patients with SS c and 38 age‐matched patients with RA were included. There was no difference in BMD measurements between patients with diffuse or limited SS c. Patients with SS c had similar risk factors associated with osteoporosis ( OP ) or low bone mass except for low body mass index ( BMI ) and low vitamin D levels compared to patients with RA . Lumbar spinal BMD and T score were similar between groups. Total hip and femoral neck BMD and T score at femoral neck and total hip were significantly lower in patient with SS c versus RA . There was significant association between m RSS , Medsger severity score (peripheral vascular involvement and skin) and femoral BMD . Conclusion There is an increased risk for bone loss in patients with SS c and the risk of OP is associated with disease severity, prolonged menopause and disease duration. The complex pathophysiology of bone metabolism as well as complex pathogenesis of the SS c pose some difficulty reaching clear‐cut conclusions on the causal relationship between SS c and bone loss.