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Correlation between bone quality and microvascular damage in systemic sclerosis patients.

Barbara Ruaro1, Andrea Casabella1,2, Sabrina Paolino1

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Systemic sclerosis (SSc) and rheumatoid arthritis (RA) patients exhibit poorer bone quality compared to healthy individuals. Bone quality in SSc correlates with microvascular damage severity, as assessed by nailfold videocapillaroscopy (NVC).

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Area of Science:

  • Rheumatology
  • Bone Metabolism
  • Vascular Biology

Background:

  • Systemic sclerosis (SSc) patients face an elevated risk of altered bone mass.
  • Microvascular damage, assessed by nailfold videocapillaroscopy (NVC), is a hallmark of SSc.
  • Understanding bone quality in SSc is crucial for comprehensive patient management.

Purpose of the Study:

  • To evaluate bone quality, using trabecular bone score (TBS), in SSc patients.
  • To correlate TBS with the severity of microvascular damage (NVC patterns) in SSc.
  • To compare bone quality in SSc patients with rheumatoid arthritis (RA) patients and healthy controls (CNT).

Main Methods:

  • Bone mineral density (BMD) and TBS of the lumbar spine (L1-L4) were analyzed using DXA scans in 84 SSc patients, 98 RA patients, and 60 CNT.
  • Nailfold videocapillaroscopy (NVC) patterns were evaluated to assess microvascular damage.
  • Statistical analyses were performed to compare bone quality parameters across groups and correlate them with NVC findings.

Main Results:

  • Both SSc and RA patients demonstrated significantly lower lumbar spine BMD and TBS compared to CNT (P < 0.001).
  • Lower TBS values were observed in SSc patients with late-stage NVC patterns compared to those with early or active patterns (P < 0.001).
  • No significant difference in mean lumbar spine TBS was found between SSc and RA patients (P = 0.238).

Conclusions:

  • SSc and RA patients exhibit significantly impaired bone quality (lower TBS and BMD) compared to healthy individuals.
  • Bone quality in SSc patients appears to be further compromised with more severe microvascular alterations (late NVC patterns).
  • These findings highlight the systemic impact of SSc and RA on bone health and the potential role of microvascular integrity.