Distal radius and tibia bone microarchitecture impairment in female patients with diffuse systemic sclerosis

Area of Science:

• Rheumatology
• Bone Metabolism
• Medical Imaging

Background:

• The skeletal impact of diffuse systemic sclerosis (dSSc) remains unclear.
• This study investigated bone density, microarchitecture, and biomechanics in the distal radius and tibia of female dSSc patients using HR-pQCT.
• The research aimed to identify clinical and laboratory factors associated with these bone changes.

Purpose of the Study:

• To evaluate bone health in female patients with diffuse systemic sclerosis (dSSc).
• To analyze volumetric bone mineral density (vBMD), microarchitecture, and biomechanical parameters in the distal radius and tibia.
• To determine the association between clinical/laboratory variables and bone parameters in dSSc.

Main Methods:

• High-resolution peripheral quantitative computed tomography (HR-pQCT) was used to assess the distal radius and tibia in 38 women with dSSc and 76 healthy controls.
• Bone mineral density (BMD), nailfold capillaroscopy (NC), range of motion (ROM), and health assessment questionnaire (HAQ) were evaluated.
• Multiple linear regression models were employed to analyze associations, adjusted for clinical and laboratory variables, ROM, and HAQ.

Main Results:

• dSSc patients exhibited significantly impaired bone density, microarchitecture, and biomechanical parameters in both the radius and tibia compared to controls (p < 0.001).
• Lower trabecular bone vBMD and trabecular number were significantly associated with acroosteolysis.
• Higher trabecular separation correlated with disease duration and reduced grip strength, while cortical vBMD was linked to ROM.

Conclusions:

• HR-pQCT revealed significant impairment of trabecular and cortical bone microarchitecture in the distal radius and tibia of dSSc patients.
• Acroosteolysis, grip strength, ROM, and disease duration are potential prognostic factors for bone impairment in dSSc.