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High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis

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Abstract

Bone mass was only previously studied in juvenile dermatomyositis/polymyositis (DM/PM) patients. Therefore, the objective this study was to evaluate the prevalence of osteoporosis and fractures in adult DM/PM. Forty female DM/PM and 78 age-, gender-, and BMI-matched healthy controls were studied. Medical charts and clinical interviews of all patients were evaluated for demographic and clinical data, including disease activity, cumulative doses of glucocorticoid, menarche and menopause age, and fractures. Bone mineral density (BMD) using dual X-ray absorptiometry (DXA) were measured at lumbar spine (L1–L4) and hip. A decreased BMD in lumbar spine [0.902 (0.136) vs. 0.965 (0.141) g/cm2, P = 0.022] and femoral neck [0.729 (0.12) vs. 0.784 (0.127) g/cm2, P = 0.027] was observed in patients compared to controls. In addition, osteoporosis was more frequent in patients than in controls in both lumbar spine (20 vs. 3.8%, P = 0.007) and the femoral neck (27.5 vs. 10.3%, P = 0.016). Moreover, a high prevalence of fractures was found in patients in comparison to healthy subjects (17.9 vs. 5.1%, P = 0.040; OR = 3.92; CI 95%:1.07–14.33). Comparing DM/PM patients with (n = 17) and without (n = 23) osteoporosis/fractures, significant differences were observed regarding age [56.8 (11.9) vs. 48.3 (13.2) years, P = 0.042], weight [62.05 (13.56) vs. 71.51 (11.46) kg, P = 0.022] and frequency of post menopausal women (94.1 vs. 65.2%, P = 0.0002). No differences were observed concerning height, lean mass, total fat mass, disease activity, mean value of creatine kinase, cumulative glucocorticoid dose, or bisphosphonate use. Logistic regression analysis revealed a negative association between the presence of osteoporosis/fractures and weight (OR: 0.92, 95% CI: 0.85–0.98; P = 0.016). This is the first study that analyzed bone mass in adult DM/PM patients and it demonstrated that about one quarter of these patients have osteoporosis/fracture.

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Acknowledgments

We are grateful to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) # 300559/2009-7 (to RMRP) and #300665/2009-1 (to JFC), Wilhelm Agricola Federico Foundation Grant (to RMRP and JFC).

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Authors and Affiliations

  1. Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455–3° andar–Reumatologia, sala 3105, São Paulo, SP, 01246-903, Brazil

    Danieli Castro Oliveira de Andrade, Sonia Cristina de Magalhães Souza, Jozélio Freire de Carvalho, Liliam Takayama, Claudia Teresa Lobato Borges & Rosa Maria Rodrigues Pereira

  2. Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brazil

    José Mendes Aldrighi

Authors
  1. Danieli Castro Oliveira de Andrade
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  2. Sonia Cristina de Magalhães Souza
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  3. Jozélio Freire de Carvalho
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  4. Liliam Takayama
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  5. Claudia Teresa Lobato Borges
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  6. José Mendes Aldrighi
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  7. Rosa Maria Rodrigues Pereira
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Correspondence to Rosa Maria Rodrigues Pereira.

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de Andrade, D.C.O., de Magalhães Souza, S.C., de Carvalho, J.F. et al. High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis. Rheumatol Int 32, 1549–1553 (2012). https://doi.org/10.1007/s00296-011-1821-2

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  • DOI: https://doi.org/10.1007/s00296-011-1821-2

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