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Cortical bone density and thickness alterations by high-resolution peripheral quantitative computed tomography: association with vertebral fractures in primary Sjögren's syndrome.
Rheumatology (Oxford). 2016 Dec; 55(12):2200-2211.R

Abstract

OBJECTIVES

To evaluate volumetric BMD (vBMD), microarchitecture and strength and vertebral fractures (VFs) in primary SS (pSS).

METHODS

We evaluated 71 female pSS patients and 71 gender-, age-, and race-matched controls. Clinical data including risk factors for osteoporosis (OP) and fractures were collected through a standardized protocol. Areal BMD and VFs were analysed by DXA. Bone microarchitecture, vBMD and bone strength were assessed by high-resolution peripheral quantitative CT (HR-pQCT), a non-invasive method.

RESULTS

pSS patients and controls were comparable for age, BMI, calcium intake, smoking, menopause, sedentary lifestyle and family history of fractures (P > 0.05). OP or low BMD for the patient's age (33.8 vs 5.6%; P < 0.0001) and VFs (19.7 vs 5.6%; P = 0.043) were more frequent in patients than controls. HR-pQCT showed deterioration of cortical and trabecular components and strength at the radius, and of cortical components and strength at the tibia (P < 0.05) in patients compared with controls. pSS patients and controls were also analysed by multivariate analysis adjusted for age, ethnicity, prednisone use, weight and height, which showed that the pSS group had lower values of cortical vBMD, cortical thickness and apparent modulus (P < 0.05) at the radius and cortical vBMD and apparent modulus (P < 0.05) at the tibia. Patients with VFs had more cortical bone deterioration (cortical vBMD/cortical thickness) at the tibia compared with patients without VFs (P < 0.05).

CONCLUSIONS

This study was the first to assess bone microarchitecture in pSS and demonstrated that cortical deterioration is the most important abnormality observed in pSS patients with VFs. This novel finding shows that this compartment contributes to vertebral fragility, suggesting that this non-invasive evaluation may be useful in the clinical practice.

Authors+Show Affiliations

Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and.Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and.Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and.Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and.RDO Diagnósticos Médicos, São Paulo, Brazil.Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and.Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (USP) and rosamariarp@yahoo.com.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27651527

Citation

Pasoto, Sandra G., et al. "Cortical Bone Density and Thickness Alterations By High-resolution Peripheral Quantitative Computed Tomography: Association With Vertebral Fractures in Primary Sjögren's Syndrome." Rheumatology (Oxford, England), vol. 55, no. 12, 2016, pp. 2200-2211.
Pasoto SG, Augusto KL, Alvarenga JC, et al. Cortical bone density and thickness alterations by high-resolution peripheral quantitative computed tomography: association with vertebral fractures in primary Sjögren's syndrome. Rheumatology (Oxford). 2016;55(12):2200-2211.
Pasoto, S. G., Augusto, K. L., Alvarenga, J. C., Takayama, L., Oliveira, R. M., Bonfa, E., & Pereira, R. M. (2016). Cortical bone density and thickness alterations by high-resolution peripheral quantitative computed tomography: association with vertebral fractures in primary Sjögren's syndrome. Rheumatology (Oxford, England), 55(12), 2200-2211.
Pasoto SG, et al. Cortical Bone Density and Thickness Alterations By High-resolution Peripheral Quantitative Computed Tomography: Association With Vertebral Fractures in Primary Sjögren's Syndrome. Rheumatology (Oxford). 2016;55(12):2200-2211. PubMed PMID: 27651527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cortical bone density and thickness alterations by high-resolution peripheral quantitative computed tomography: association with vertebral fractures in primary Sjögren's syndrome. AU - Pasoto,Sandra G, AU - Augusto,Kristopherson L, AU - Alvarenga,Jackeline C, AU - Takayama,Liliam, AU - Oliveira,Ricardo M, AU - Bonfa,Eloisa, AU - Pereira,Rosa M R, Y1 - 2016/09/19/ PY - 2015/12/19/received PY - 2016/08/06/revised PY - 2016/9/22/pubmed PY - 2017/5/23/medline PY - 2016/9/22/entrez KW - HR-pQCT KW - Sjögren’s syndrome KW - bone microarchitecture KW - bone strength KW - osteoporosis KW - vertebral fractures SP - 2200 EP - 2211 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 55 IS - 12 N2 - OBJECTIVES: To evaluate volumetric BMD (vBMD), microarchitecture and strength and vertebral fractures (VFs) in primary SS (pSS). METHODS: We evaluated 71 female pSS patients and 71 gender-, age-, and race-matched controls. Clinical data including risk factors for osteoporosis (OP) and fractures were collected through a standardized protocol. Areal BMD and VFs were analysed by DXA. Bone microarchitecture, vBMD and bone strength were assessed by high-resolution peripheral quantitative CT (HR-pQCT), a non-invasive method. RESULTS: pSS patients and controls were comparable for age, BMI, calcium intake, smoking, menopause, sedentary lifestyle and family history of fractures (P > 0.05). OP or low BMD for the patient's age (33.8 vs 5.6%; P < 0.0001) and VFs (19.7 vs 5.6%; P = 0.043) were more frequent in patients than controls. HR-pQCT showed deterioration of cortical and trabecular components and strength at the radius, and of cortical components and strength at the tibia (P < 0.05) in patients compared with controls. pSS patients and controls were also analysed by multivariate analysis adjusted for age, ethnicity, prednisone use, weight and height, which showed that the pSS group had lower values of cortical vBMD, cortical thickness and apparent modulus (P < 0.05) at the radius and cortical vBMD and apparent modulus (P < 0.05) at the tibia. Patients with VFs had more cortical bone deterioration (cortical vBMD/cortical thickness) at the tibia compared with patients without VFs (P < 0.05). CONCLUSIONS: This study was the first to assess bone microarchitecture in pSS and demonstrated that cortical deterioration is the most important abnormality observed in pSS patients with VFs. This novel finding shows that this compartment contributes to vertebral fragility, suggesting that this non-invasive evaluation may be useful in the clinical practice. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/27651527/Cortical_bone_density_and_thickness_alterations_by_high_resolution_peripheral_quantitative_computed_tomography:_association_with_vertebral_fractures_in_primary_Sj��gren's_syndrome_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kew332 DB - PRIME DP - Unbound Medicine ER -