Title:Bone Metabolism Alterations in Systemic Sclerosis: An Insight into Bone
Disease in SSc: From the Radiographic Findings to their Potential
Pathogenesis and Outcome
Volume: 18
Issue: 4
Author(s): Stefania Sciacca*, Addolorata Corrado, Cinzia Rotondo and Francesco Paolo Cantatore
Affiliation:
- Department of Medical and Surgical Sciences, Rheumatology Clinic, University of Foggia Medical School, Foggia 71122, Italy
Keywords:
Systemic sclerosis, calcinosis, bone mineral density, risk fracture, acroosteolysis, osteoporosis, bone turnover markers, vitamin D.
Abstract: Previous research has shown conflicting reports about the effect of systemic sclerosis
(SSc) on bone metabolism, especially considering bone mineral density (BMD), bone microarchitecture,
and risk of fracture. The objective of this review is to analyze data from previous articles to
investigate the differences in BMD and fracture risk between SSc and non-SSc populations and to
discuss potential underlying mechanisms. The main factors investigated have been BMD (mean and
standard deviation), t-scores and z-scores at the lumbar spine, femoral neck, and total hip measured
by dual-energy X-ray absorptiometry (DEXA), bone remodeling markers, fracture prevalence, and
incidence, trabecular bone score (TBS), musculoskeletal involvement with particular correlation to
SSc skin subtype and extent, disease duration, serological pattern, and vitamin D levels. Since microvascular
alterations evaluated through nailfold videocapillaroscopy (NVC) of SSc patients have
recently been correlated with decreased BMD and bone microarchitecture, the vascular impairment
in SSc has been proposed as a remarkable contributing element in bone remodeling, and the role of
hypoxia has been investigated.