Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Apr;39(4):1181-1189.
doi: 10.1007/s10067-019-04847-0. Epub 2019 Dec 14.

A meta-analysis of fracture risk and bone mineral density in patients with systemic sclerosis

Juan Chen  1 , Ling Lei  2 , Jie Pan  1 , Cheng Zhao  1
Affiliations
Meta-Analysis

A meta-analysis of fracture risk and bone mineral density in patients with systemic sclerosis

Juan Chen et al. Clin Rheumatol. 2020 Apr.

Abstract

Introduction: Osteoporosis and fractures are important public health issues that impose serious burdens on patients. Patients with systemic sclerosis (SSc) have low bone mineral density (BMD) and increased risk for fracture. We aimed to explore the association between SSc and BMD and fracture risk.

Methods: For this meta-analysis, we analyzed data from articles that reported mean differences in BMD or fracture risk between patients with SSc and controls. We undertook a systematic literature search of the PubMed, Web of Science, and Cochrane Library databases. The pooled weighted mean difference (WMD) was used to estimate the mean difference in BMD between patients with SSc and controls. Pooled odds ratios (ORs; with 95% confidence intervals [95% CIs]) were used to assess the association between SSc and fracture risk.

Results: Analysis of the results from 18 studies showed that patients with SSc had significantly lower BMD than controls in the following categories: whole body (WMD - 0.07, 95% CI - 0.1 to - 0.04, p < 0.00001), lumbar spine (WMD - 0.08, 95% CI - 0.11 to - 0.05, p < 0.00001), femoral neck (WMD: -0.28, 95% CI: -0.46 to -0.10, p=0.002), total hip (WMD - 0.10, 95% CI - 0.14 to - 0.06, p < 0.00001), and femoral trochanter (WMD - 0.06, 95% CI - 0.09 to - 0.03, p < 0.0001). Moreover, patients with SSc had an increased risk of vertebral fracture (OR 10.38, 95% CI 1.19 to 90.58, p = 0.03). We did not find a significant difference in the risk of osteoporotic fracture between patients with SSc and controls (OR = 2.24, 95% CI 0.58 to 8.59, p = 0.24).

Conclusion: Patients with SSc have a significant reduction in bone mass, and these patients have an increased risk of vertebral fracture. The early monitoring of BMD in patients with SSc is recommended for the prevention of osteoporosis and fracture.Key points• SSc patients have a significant low BMD• SSc patients also have an increased risk of vertebral fracture.

Keywords: Bone mineral density; Fracture risk; Systemic sclerosis.

PubMed Disclaimer

Comment in

References

    1. Baron M, Lee P (1982) The articular manifestations of progressive systemic sclerosis (scleroderma). Ann Rheum Dis 41(2):147–152 - DOI
    1. Johnson SR, Glaman DD, Schentag CT (2006) Quality of life and functional status in systemic sclerosis compared to other rheumatic diseases. J Rheumatol 33(6):1117–1122 - PubMed
    1. Saketkoo LA, Magnus JH, Doyle MK (2014) The primary care physician in the early diagnosis of systemic sclerosis:the cornerstone of recognition and hope. Am J Med Sci 347(1):54–63. https://doi.org/10.1097/MAJ.0b013e3182a55d24 - DOI - PubMed
    1. Bijlsma AY, Meskers CG, Westendorp RG, Maier AB (2012) Chronology of age-related disease definitions: osteoporosis and sarcopenia. Ageing Res Rev 11(2):320–324. https://doi.org/10.1016/j.arr.2012.01.001 - DOI - PubMed
    1. Rachner TD, Khosla S (2011) Osteoporosis: now and the future. Lancet 377(9773):1276–1287. https://doi.org/10.1016/S0140-6736(10)62349-5 - DOI - PubMed - PMC

MeSH terms

LinkOut - more resources