Scleroderma Patients May Have Increased Risk of Osteoporosis

Osteoporosis Prevalence in Scleroderma Patients Comparable to RA Patients

Scleroderma patients may have an increased risk of developing osteoporosis. Researchers compared the risk of developing osteoporosis among patients who had scleroderma, rheumatoid arthritis, or noninflammatory musculoskeletal disease. Which of the groups had higher prevalence of osteoporosis and how was prevalence determined?

Studies Assess Osteoporosis in Scleroderma Patients

According to a study published in the June 2008 Journal of Rheumatology, researchers sent a survey to 129 patients with scleroderma, 158 people with noninflammatory musculoskeletal disease, and 230 rheumatoid arthritis patients. Questions about demographics, diagnosis of osteoporosis, and risk factors for osteoporosis were included in the survey. Bone mineral density test results were also compared.

Survey results revealed that the prevalence of osteoporosis in scleroderma patients was similar to the prevalence of osteoporosis in rheumatoid arthritis patients -- but higher than the prevalence of osteoporosis in the noninflammatory musculoskeletal group. Scleroderma patients reported greater disability but less family history of osteoporosis compared to the noninflammatory musculoskeletal group. Among the three groups studied, there was no difference in fracture or osteoporosis-related fracture.

Interestingly, scleroderma patients were less likely to have had a bone mineral density test in the past compared to rheumatoid arthritis patients. Bone mineral density scores of scleroderma patients were similar to or lower than those for rheumatoid arthritis patients.

What Explains the Prevalence of Osteoporosis in Scleroderma Patients?

Previous studies have been somewhat inconclusive about the link between scleroderma and osteoporosis. One study stated, "Earlier menopause, corticosteroid use in some patients, and other factors secondary to scleroderma (such as malabsorption and inflammation), may be causal factors or may be confounders in studies of osteoporosis in scleroderma."

While one study suggested there may be confounding factors that account for the prevalence of osteoporosis in scleroderma, another study concluded "scleroderma may be an independent factor for low bone mineral density". Whether or not there are additional factors contributing to the development of osteoporosis in scleroderma, it is clear that bone mineral density should be monitored in scleroderma patients. If you aren't being tested on a regular basis, discuss your concerns with your doctor and ask to have a bone mineral density test ordered for you.

_Sources:

Osteoporosis in Scleroderma. Semin Arthritis Rheum. Loucks J. February 2005.
http://www.ncbi.nlm.nih.gov/pubmed/15692961?dopt=Abstract

Systemic sclerosis and bone loss: the role of the disease and body composition. Scandinavian Journal of Rheumatology. Sept-Oct 2006. Souza RB et al.
http://www.ncbi.nlm.nih.gov/pubmed/17062439

Patients with Scleroderma May Have Increased Risk of Osteoporosis. A Comparison to Rheumatoid Arthritis and Noninflammatory Musculoskeletal Conditions. Yuen SY et al. Journal of Rheumatology. June 2008.
http://www.jrheum.com/abstracts/abstracts08/1073.html