Department of Internal Medicine DiMI, Research Laboratory and Academic Division of Clinical Rheumatology, University of Genoa, IRCCS San Martino Polyclinic, Genoa, Italy.
Endocrinology Unit, IRCCS Policlinico San Martino, Genoa, Italy.
J Endocrinol Invest. 2021 Feb;44(2):255-264. doi: 10.1007/s40618-020-01234-4. Epub 2020 May 24.
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).
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.
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.
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.
根据甲襞微血管检查（NVC）评估和评分的外周微循环情况（“早期”、“活动期”、“晚期”模式），评估和比较系统性硬化症（SSc）患者的身体成分和骨骼状况。
使用双能 X 线吸收仪（GE Lunar USA）和专用软件评估 37 名女性 SSc 患者（根据 2013 年 EULAR/ACR 标准分类）和 40 名性别匹配的健康对照者的身体成分和骨矿物质密度（BMD）。根据不同的 NVC 模式分析临床、实验室、身体成分和骨骼参数。采用学生 t 检验或单因素方差分析比较均值；采用 Kruskal-Wallis 检验比较中位数；采用卡方检验比较频率。
SSc 患者的椎体（21%比 7%）和股骨（35%比 7%）骨质疏松症（OP）患病率较高。特别是“晚期”NVC 模式的 SSc 患者，椎体（p=0.018）和股骨 OP（p=0.016）的患病率明显更高。对七个不同身体部位的骨量（BM）进行区域评估发现，只有在严重微血管损伤时，总脊柱（p=0.008）和股骨颈（p=0.027）的 BMD 显著降低。“晚期”NVC 模式的患者与“早期”和“活动期”NVC 模式相比，全身瘦体重（LM）明显较低，特别是在上肢。值得注意的是，根据 NVC 模式的严重程度，所有部位的 BMD 与 LM 和 BMC 相关。
微血管损伤最严重的 SSc 患者的身体成分和骨骼状况明显改变，表明微血管衰竭与相关的肌肉/骨骼受累之间存在很强的联系。
