Risk factors for low bone mineral density in postmenopausal women with systemic sclerosis
A. O. Efremova,
N. V. Toroptsova,
O. V. Dobrovolskaya,
M. N. Starovoitova,
O. V. Desinova,
O. A. Nikitinskaya https://doi.org/10.47360/1995-4484-2021-592-598
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.
About the Authors
A. O. Efremova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Arina Efremova
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
N. V. Toroptsova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
O. V. Dobrovolskaya
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
M. N. Starovoitova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
O. V. Desinova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
O. A. Nikitinskaya
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
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For citations:
Efremova A.O., Toroptsova N.V., Dobrovolskaya O.V., Starovoitova M.N., Desinova O.V., Nikitinskaya O.A. Risk factors for low bone mineral density in postmenopausal women with systemic sclerosis. Rheumatology Science and Practice. 2021;59(5):592-598. (In Russ.) https://doi.org/10.47360/1995-4484-2021-592-598
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