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

J Endocrinol Invest. 2021 Feb;44(2):255-264. doi: 10.1007/s40618-020-01234-4. Epub 2020 May 24.


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.

Keywords: Body composition; Bone mineral density; Capillaroscopy; Connective tissue diseases; Rheumatic diseases; Sarcopenia; Systemic sclerosis.

MeSH terms

  • Aged
  • Body Composition
  • Bone Diseases, Metabolic / epidemiology
  • Bone Diseases, Metabolic / etiology
  • Bone Diseases, Metabolic / pathology*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Italy / epidemiology
  • Male
  • Microcirculation*
  • Middle Aged
  • Osteoporosis / epidemiology
  • Osteoporosis / etiology
  • Osteoporosis / pathology*
  • Prognosis
  • Retrospective Studies
  • Scleroderma, Systemic / complications*