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Body composition and bone status in relation to microvascular damage in systemic sclerosis patients

  • Original Article
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Abstract

Aim

To evaluate, in Systemic sclerosis (SSc) patients, the body composition and the bone status according to the peripheral microcirculatory condition, assessed and scored by nailfold videocapillaroscopy (NVC, “Early”, “Active”, “Late” patterns).

Methods

Body composition and bone mineral density (BMD) were assessed by Dual X-ray absorptiometry and dedicated software (GE Lunar USA) in 37 female SSc patients classified according to the 2013 EULAR/ACR criteria and 40 sex-matched healthy subjects. Clinical, laboratory, body composition and bone parameters were analyzed according to the different NVC patterns. Means were compared by the Student’s t test or one-way analysis of variance; medians were compared by the Kruskal–Wallis test; and frequencies by the chi-square test.

Results

Higher prevalence of vertebral (21% vs 7%) and femoral (35% vs 7%) osteoporosis (OP) was found in SSc. Particularly SSc patients with “Late” NVC pattern showed a significantly higher prevalence of vertebral (p = 0.018) and femoral OP (p = 0.016). Regional assessment of bone mass (BM) in seven different body areas showed a significantly lower BMD only at the total spine (p = 0.008) and femoral neck (p = 0.027) in advanced microvascular damage. Patients with “Late” NVC pattern showed a lower whole-body lean mass (LM) compared to “Early” and “Active” NVC patterns, particularly at upper limbs. To note, in all body sites, BMD correlates with LM and BMC according to NVC pattern severity.

Conclusions

SSc patients with most severe microvascular damage show a significantly altered body composition and bone status suggesting a strong link between microvascular failure and associated muscle/bone sufferance.

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Acknowledgements

Dr. De Gregorio Sara for graphic support. V. Smith is Senior Clinical Investigator of the Research Foundation - Flanders (Belgium) (FWO) (grant no.: 1.8.029.15N).

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Author notes

  1. V. Smith and M. Cutolo are shared last author.

Authors and Affiliations

  1. Department of Internal Medicine DiMI, Research Laboratory and Academic Division of Clinical Rheumatology, University of Genoa, IRCCS San Martino Polyclinic, Genoa, Italy

    S. Paolino, E. Gotelli, F. Goegan, A. Casabella, G. Ferrari, M. Patane, C. Pizzorni, F. Cattelan, A. Sulli & M. Cutolo

  2. Endocrinology Unit, IRCCS Policlinico San Martino, Genoa, Italy

    M. Albertelli & F. Gatto

  3. Endocrinology Unit, Department of Internal Medicine and Medical Specialities (DIMI), Centre of Excellence for Biomedical Research (CEBR), Endocrinology Unit, University of Genoa, IRCCS Policlinico San Martino, Genoa, Italy

    M. Albertelli & F. Gatto

  4. Department of Internal Medicine, Ghent University, Ghent, Belgium

    V. Smith

  5. Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

    V. Smith

  6. Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium

    V. Smith

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I testify on behalf of all co-authors that in our article. SP, EG, FG, AC, GF, MP, MA, FG, CP, AS, VS, MC submitted to Journal of Endocrinological Investigation: (1) the material has not been published in whole or in part elsewhere; (2) the manuscript is not currently being considered for publication in another journal; (3) all authors have been personally and actively involved in substantive work leading to the manuscript, and will hold themselves jointly and individually responsible for its content.

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The study was conducted in accordance with the principles of Good Clinical Practices and the declaration of Helsinski. All the standard clinical investigations performed at the Scleroderma Clinic have been approved by local Ethical Board Committee (EBC).

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Paolino, S., Gotelli, E., Goegan, F. et al. Body composition and bone status in relation to microvascular damage in systemic sclerosis patients. J Endocrinol Invest 44, 255–264 (2021). https://doi.org/10.1007/s40618-020-01234-4

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