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Low trabecular bone score is associated with high C-reactive protein levels in systemic sclerosis


 Objectives

To evaluate trabecular bone score (TBS) in patients with systemic sclerosis (SSc) and to identify risk factors related to low TBS in SSc.
Methods

TBS and areal bone mineral density (aBMD) were assessed in patients with SSc (n = 57), rheumatoid arthritis (RA) (n = 47), and hand osteoarthritis (OA) (n = 37) using DXA. Osteoporosis risk factors, laboratory findings, SSc-specific organ involvement, and patterns of nailfold capillaroscopy (NFC) were also assessed. Multivariate linear regression analysis was performed to identify the risk factors associated with TBS in SSc patients.
Results

The median TBS (Q1, Q3) value was 1.378 (1.322, 1.425) in SSc patients, 1.336 (1.261, 1.396) for RA patients, and 1.430 (1.387, 1.438) for controls (p < 0.001). No significant differences were observed in the median lumbar spine TBS and aBMD at the lumbar spine, femoral neck, and total hip between the SSc and RA groups. The TBS was negatively correlated with the erythrocyte sedimentation rate (p = 0.042) and C-reactive protein (CRP) (p = 0.005) in the SSc group only and with cumulative glucocorticoid doses in the RA group only (p = 0.031). We found no association between TBS and SSc cutaneous subtype, internal organ involvement, autoantibody profile, NFC patterns, and use of immunosuppressive agents, such as cyclophosphamide. In the multivariate analyses, age, female sex, current, and average CRP were significantly associated with TBS.
Conclusions

TBS assessment revealed poor bone quality in patients with SSc, similar to those with RA. CRP levels were negatively correlated with TBS in patients with SSc, and higher CRP levels were independently associated with low TBS.