FRI0259 Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study to rheumatoid arthritis and healthy controls
Objectives To investigate whether women with SSc have increased risk of OP and fractures compared to a “high risk” population with rheumatoid arthritis (RA) and also healthy controls. Methods Cross-sectional study with successive inclusion of age-matched healthy, SSc, and RA women on a 18-month peri...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2013-06, Vol.71 (Suppl 3), p.401-402 |
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| creator | Avouac, J. Koumakis, E. Toth, E. Meunier, M. Maury, E. Cormier, C. Kahan, A. Allanore, Y. |
| description | Objectives To investigate whether women with SSc have increased risk of OP and fractures compared to a “high risk” population with rheumatoid arthritis (RA) and also healthy controls. Methods Cross-sectional study with successive inclusion of age-matched healthy, SSc, and RA women on a 18-month period. Risk factors for OP and fractures, including age, menopausal status, calcium/vitamin D intake, family history, comorbidity and steroid use, were collected for all patients. Bone mineral density (BMD) was assessed at AP lumbar spine (L1-L4), femoral neck, and total hip region with DXA Prodigy (GE-Lunar) or QDR4500 (Hologic). We included 71 women with SSc (62±12 years old), 139 with RA (61±11 years old) and 227 healthy controls (60±8 years old). The mean ± standard deviation, SD, disease duration of SSc and RA patients was 10±9 and 18±13 years respectively (p |
| doi_str_mv | 10.1136/annrheumdis-2012-eular.2716 |
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Methods Cross-sectional study with successive inclusion of age-matched healthy, SSc, and RA women on a 18-month period. Risk factors for OP and fractures, including age, menopausal status, calcium/vitamin D intake, family history, comorbidity and steroid use, were collected for all patients. Bone mineral density (BMD) was assessed at AP lumbar spine (L1-L4), femoral neck, and total hip region with DXA Prodigy (GE-Lunar) or QDR4500 (Hologic). We included 71 women with SSc (62±12 years old), 139 with RA (61±11 years old) and 227 healthy controls (60±8 years old). The mean ± standard deviation, SD, disease duration of SSc and RA patients was 10±9 and 18±13 years respectively (p<0.001). SSc and RA patients were more likely to receive vitamin D (69% and 76% vs. 25%, p<0.001 for both comparisons) and calcium (48% and 72% vs. 14%, p<0.001 for both comparisons) supplementation than healthy controls. RA Patients were more likely to receive calcium supplementation (100 (72%) vs. 34 (48%), p<0.001) and corticosteroids (129 (93%) vs. 41 (58%), p<0.001) than SSc patients. Cumulative dose of corticosteroids and CRP were significantly higher in patients with RA than SSc (39554±29661 mg vs.19392±19333 mg, p<0.0001 and 12±16 mg/l vs. 7±7.9 mg/l, p=0.01). Results The point prevalence of OP (T-score <-2.5) was similar in SSc and RA (30% and 32% respectively), and was for both significantly higher than in healthy controls (11%, p<0.001 vs. SSc and RA). The frequency of lumbar spine and total hip OP did not differ between SSc and RA. The point prevalence of fractures was 35% and 33% in SSc and RA, respectively (p=NS) and 10% in healthy controls (p<0.001 vs. SSc and RA). The frequency of vertebral (25% and 19%) and non-vertebral fracture (23% and 22%) did not differ between SSc and RA. Multivariate analysis identified disease duration as the only risk factor of OP in SSc (odds ratio, OR: 1.21, 95% confidence interval, CI: 1.02-1.30). There was no association between OP and corticosteroid intake, cumulative dose of corticosteroids, systemic inflammation (CRP >10mg/l) or any SSc feature Age (OR: 1.21, 95% CI 1.03-1.38) and low 25(OH)D levels (OR: 6.02, 95% CI 1.46-24.78) were recognized as risk factors of fracture in SSc. In comparison, age (OR: 1.12, 95% CI 1.02-1.26) and corticosteroid treatment (OR: 3.21, 95% CI: 1.12-10.44) were independently associated with OP in RA. Cumulative dose of corticosteroids negatively correlated with BMD measured at lumbar spine (r=0.38, p=0.01) and total hip (r=0.49, p=0.008) in RA patients. Multivariate analysis confirmed age (OR: 1.09, 95% CI 1.03-1.18), OP (OR: 3.22, 95% CI 1.18-8.75) and low 25(OH)D levels (OR: 4.31, 95% CI 1.29-14.41) as independent risk factors of fractures in RA. Conclusions 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. Thus, increasing the awareness and performance of BMD measurements together with vitamin D supply in patients with SSc is warranted. Disclosure of Interest None Declared]]></description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/annrheumdis-2012-eular.2716</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>Kidlington: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><ispartof>Annals of the rheumatic diseases, 2013-06, Vol.71 (Suppl 3), p.401-402</ispartof><rights>2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2013 (c) 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/71/Suppl_3/401.3.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/71/Suppl_3/401.3.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids></links><search><creatorcontrib>Avouac, J.</creatorcontrib><creatorcontrib>Koumakis, E.</creatorcontrib><creatorcontrib>Toth, E.</creatorcontrib><creatorcontrib>Meunier, M.</creatorcontrib><creatorcontrib>Maury, E.</creatorcontrib><creatorcontrib>Cormier, C.</creatorcontrib><creatorcontrib>Kahan, A.</creatorcontrib><creatorcontrib>Allanore, Y.</creatorcontrib><title>FRI0259 Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study to rheumatoid arthritis and healthy controls</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description><![CDATA[Objectives To investigate whether women with SSc have increased risk of OP and fractures compared to a “high risk” population with rheumatoid arthritis (RA) and also healthy controls. Methods Cross-sectional study with successive inclusion of age-matched healthy, SSc, and RA women on a 18-month period. Risk factors for OP and fractures, including age, menopausal status, calcium/vitamin D intake, family history, comorbidity and steroid use, were collected for all patients. Bone mineral density (BMD) was assessed at AP lumbar spine (L1-L4), femoral neck, and total hip region with DXA Prodigy (GE-Lunar) or QDR4500 (Hologic). We included 71 women with SSc (62±12 years old), 139 with RA (61±11 years old) and 227 healthy controls (60±8 years old). The mean ± standard deviation, SD, disease duration of SSc and RA patients was 10±9 and 18±13 years respectively (p<0.001). SSc and RA patients were more likely to receive vitamin D (69% and 76% vs. 25%, p<0.001 for both comparisons) and calcium (48% and 72% vs. 14%, p<0.001 for both comparisons) supplementation than healthy controls. RA Patients were more likely to receive calcium supplementation (100 (72%) vs. 34 (48%), p<0.001) and corticosteroids (129 (93%) vs. 41 (58%), p<0.001) than SSc patients. Cumulative dose of corticosteroids and CRP were significantly higher in patients with RA than SSc (39554±29661 mg vs.19392±19333 mg, p<0.0001 and 12±16 mg/l vs. 7±7.9 mg/l, p=0.01). Results The point prevalence of OP (T-score <-2.5) was similar in SSc and RA (30% and 32% respectively), and was for both significantly higher than in healthy controls (11%, p<0.001 vs. SSc and RA). The frequency of lumbar spine and total hip OP did not differ between SSc and RA. The point prevalence of fractures was 35% and 33% in SSc and RA, respectively (p=NS) and 10% in healthy controls (p<0.001 vs. SSc and RA). The frequency of vertebral (25% and 19%) and non-vertebral fracture (23% and 22%) did not differ between SSc and RA. Multivariate analysis identified disease duration as the only risk factor of OP in SSc (odds ratio, OR: 1.21, 95% confidence interval, CI: 1.02-1.30). There was no association between OP and corticosteroid intake, cumulative dose of corticosteroids, systemic inflammation (CRP >10mg/l) or any SSc feature Age (OR: 1.21, 95% CI 1.03-1.38) and low 25(OH)D levels (OR: 6.02, 95% CI 1.46-24.78) were recognized as risk factors of fracture in SSc. In comparison, age (OR: 1.12, 95% CI 1.02-1.26) and corticosteroid treatment (OR: 3.21, 95% CI: 1.12-10.44) were independently associated with OP in RA. Cumulative dose of corticosteroids negatively correlated with BMD measured at lumbar spine (r=0.38, p=0.01) and total hip (r=0.49, p=0.008) in RA patients. Multivariate analysis confirmed age (OR: 1.09, 95% CI 1.03-1.18), OP (OR: 3.22, 95% CI 1.18-8.75) and low 25(OH)D levels (OR: 4.31, 95% CI 1.29-14.41) as independent risk factors of fractures in RA. Conclusions 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. Thus, increasing the awareness and performance of BMD measurements together with vitamin D supply in patients with SSc is warranted. Disclosure of Interest None Declared]]></description><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNqVkctu1DAUhi0EEkPhHSx1neJb7LhdtQNtR6qKxG1rOcmJ4mkST20HmF03vAPP1yepZ6ZCbNn4yEf_f24fQseUnFDK5Xs7TaGHeWxdLBihrIB5sOGEKSpfoAUVssppSV6iBSGEF0JL9Rq9iXGdv6Si1QL9ufy8IqzUjw-_V1MTwEZocXDxDvsO-5jAb3zw0UVspxZ3wTZpDoDdhH_6EfLrUo_jNgtH1-DYDLBXn-Jz3PhxY4NN7gfgmOZ2i5PH-3Ft8q7FNqQ-uPRcugc7pH6bXVMKfohv0avODhHePccj9O3y49fldXHz6Wq1PL8paipLntcTurZMlYxXHdGCMUkEMNu2FbNSCq3bWmsBAigpqSaSNlRWjFPb1RyI4Efo-FB3E_z9DDGZtZ_DlFsaqpTSShHGs-rsoGryejFAZzbBjTZsDSVmh8L8g8LsUJg9CrNDkd3Fwe3ynX79tdpwZ6TiqjS335fmll0wdv3lg9nNJA_6elz_V6MnsT2mxw</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Avouac, J.</creator><creator>Koumakis, E.</creator><creator>Toth, E.</creator><creator>Meunier, M.</creator><creator>Maury, E.</creator><creator>Cormier, C.</creator><creator>Kahan, A.</creator><creator>Allanore, Y.</creator><general>BMJ Publishing Group Ltd and European League Against Rheumatism</general><general>Elsevier Limited</general><scope>BSCLL</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20130601</creationdate><title>FRI0259 Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study to rheumatoid arthritis and healthy controls</title><author>Avouac, J. ; Koumakis, E. ; Toth, E. ; Meunier, M. ; Maury, E. ; Cormier, C. ; Kahan, A. ; Allanore, Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1653-2049ba275238f09422604e2add82a66499db994e4e10519061c168231afb3e043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Avouac, J.</creatorcontrib><creatorcontrib>Koumakis, E.</creatorcontrib><creatorcontrib>Toth, E.</creatorcontrib><creatorcontrib>Meunier, M.</creatorcontrib><creatorcontrib>Maury, E.</creatorcontrib><creatorcontrib>Cormier, C.</creatorcontrib><creatorcontrib>Kahan, A.</creatorcontrib><creatorcontrib>Allanore, Y.</creatorcontrib><collection>Istex</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Avouac, J.</au><au>Koumakis, E.</au><au>Toth, E.</au><au>Meunier, M.</au><au>Maury, E.</au><au>Cormier, C.</au><au>Kahan, A.</au><au>Allanore, Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>FRI0259 Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study to rheumatoid arthritis and healthy controls</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>71</volume><issue>Suppl 3</issue><spage>401</spage><epage>402</epage><pages>401-402</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract><![CDATA[Objectives To investigate whether women with SSc have increased risk of OP and fractures compared to a “high risk” population with rheumatoid arthritis (RA) and also healthy controls. Methods Cross-sectional study with successive inclusion of age-matched healthy, SSc, and RA women on a 18-month period. Risk factors for OP and fractures, including age, menopausal status, calcium/vitamin D intake, family history, comorbidity and steroid use, were collected for all patients. Bone mineral density (BMD) was assessed at AP lumbar spine (L1-L4), femoral neck, and total hip region with DXA Prodigy (GE-Lunar) or QDR4500 (Hologic). We included 71 women with SSc (62±12 years old), 139 with RA (61±11 years old) and 227 healthy controls (60±8 years old). The mean ± standard deviation, SD, disease duration of SSc and RA patients was 10±9 and 18±13 years respectively (p<0.001). SSc and RA patients were more likely to receive vitamin D (69% and 76% vs. 25%, p<0.001 for both comparisons) and calcium (48% and 72% vs. 14%, p<0.001 for both comparisons) supplementation than healthy controls. RA Patients were more likely to receive calcium supplementation (100 (72%) vs. 34 (48%), p<0.001) and corticosteroids (129 (93%) vs. 41 (58%), p<0.001) than SSc patients. Cumulative dose of corticosteroids and CRP were significantly higher in patients with RA than SSc (39554±29661 mg vs.19392±19333 mg, p<0.0001 and 12±16 mg/l vs. 7±7.9 mg/l, p=0.01). Results The point prevalence of OP (T-score <-2.5) was similar in SSc and RA (30% and 32% respectively), and was for both significantly higher than in healthy controls (11%, p<0.001 vs. SSc and RA). The frequency of lumbar spine and total hip OP did not differ between SSc and RA. The point prevalence of fractures was 35% and 33% in SSc and RA, respectively (p=NS) and 10% in healthy controls (p<0.001 vs. SSc and RA). The frequency of vertebral (25% and 19%) and non-vertebral fracture (23% and 22%) did not differ between SSc and RA. Multivariate analysis identified disease duration as the only risk factor of OP in SSc (odds ratio, OR: 1.21, 95% confidence interval, CI: 1.02-1.30). There was no association between OP and corticosteroid intake, cumulative dose of corticosteroids, systemic inflammation (CRP >10mg/l) or any SSc feature Age (OR: 1.21, 95% CI 1.03-1.38) and low 25(OH)D levels (OR: 6.02, 95% CI 1.46-24.78) were recognized as risk factors of fracture in SSc. In comparison, age (OR: 1.12, 95% CI 1.02-1.26) and corticosteroid treatment (OR: 3.21, 95% CI: 1.12-10.44) were independently associated with OP in RA. Cumulative dose of corticosteroids negatively correlated with BMD measured at lumbar spine (r=0.38, p=0.01) and total hip (r=0.49, p=0.008) in RA patients. Multivariate analysis confirmed age (OR: 1.09, 95% CI 1.03-1.18), OP (OR: 3.22, 95% CI 1.18-8.75) and low 25(OH)D levels (OR: 4.31, 95% CI 1.29-14.41) as independent risk factors of fractures in RA. Conclusions 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. Thus, increasing the awareness and performance of BMD measurements together with vitamin D supply in patients with SSc is warranted. Disclosure of Interest None Declared]]></abstract><cop>Kidlington</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><doi>10.1136/annrheumdis-2012-eular.2716</doi><tpages>2</tpages></addata></record> |
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| title | FRI0259 Increased risk of osteoporosis and fracture in women with systemic sclerosis: A comparative study to rheumatoid arthritis and healthy controls |
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