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Osteoporosis in scleroderma.

Jennifer Loucks1, Janet E Pope

  • 1Department of Medicine, Division of Rheumatology, University of Western Ontario, London, Canada.

Seminars in Arthritis and Rheumatism
|February 5, 2005
PubMed
Summary
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The link between osteoporosis and scleroderma remains unclear. Studies show no consistent evidence of lower bone density in scleroderma patients, with confounding factors like early menopause potentially influencing results.

Area of Science:

  • Rheumatology
  • Endocrinology
  • Bone Metabolism

Background:

  • Scleroderma (systemic sclerosis, SSc) is a chronic autoimmune disease characterized by fibrosis and vascular abnormalities.
  • Osteoporosis (OP) is a skeletal disorder characterized by reduced bone mass and microarchitectural deterioration, leading to increased bone fragility.
  • The potential association between SSc and OP requires investigation due to shared risk factors and potential disease-related impacts on bone health.

Purpose of the Study:

  • To systematically review the existing literature on the association between osteoporosis and scleroderma.
  • To evaluate the evidence for increased osteoporosis prevalence or reduced bone mineral density in patients with systemic sclerosis.

Main Methods:

  • A comprehensive literature search was conducted using Medline (PubMed) from 1966 to 2004.

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  • Search terms included "scleroderma," "systemic sclerosis," "osteoporosis," "bone mineral density," "bone densitometry," and "prevalence."
  • Included studies were case-control and retrospective designs investigating the OP-SSc relationship.

    • Main Results:

    • Eight case-control studies and one retrospective study were identified.
    • No clear association was found between bone mineral density (BMD) scores and scleroderma.
    • Some studies reported lower BMD in SSc patients, but did not adequately control for confounding factors such as earlier menopause, corticosteroid use, malabsorption, or inflammation.

    Conclusions:

    • The evidence does not strongly support a consistently higher prevalence of osteoporosis in scleroderma patients.
    • Confounding factors, including earlier menopause and SSc-related complications, likely contribute to observed associations.
    • Further well-designed studies with larger sample sizes are needed to clarify the relationship between osteoporosis and scleroderma.