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Clinical Rheumatology

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01-04-2020 | Systemic Sclerosis | Original Article

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

Authors: Juan Chen, Ling Lei, Jie Pan, Cheng Zhao

Published in: Clinical Rheumatology | Issue 4/2020

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

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Title: A meta-analysis of fracture risk and bone mineral density in patients with systemic sclerosis
Authors: Juan Chen
Ling Lei
Jie Pan
Cheng Zhao
Publication date: 01-04-2020
Publisher: Springer London
Keyword: Systemic Sclerosis
Published in: Clinical Rheumatology / Issue 4/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04847-0

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

Abstract

Introduction

Methods

Results

Conclusion

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Abstract

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