ArticleCalcified tissue international2026
Compartment-specific skeletal involvement in systemic sclerosis characterized by peripheral QCT and serum osteoimmune mediators: a case-control study.
Article in Calcified tissue international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Systemic sclerosis (SSc) is associated with increased bone fragility, yet early, compartment-specific alterations and their osteoimmunological correlates remain incompletely characterized. This study aimed to assess bone status in SSc using dual X-ray absorptiometry (DXA) complemented by peripheral quantitative computed tomography (pQCT), and to evaluate their associations with a targeted osteoimmunological biomarker panel and clinical risk scores. This prospective cross-sectional study included 40 women with SSc (disease duration ≤ 7 years from diagnosis) and 45 non-immune female controls, frequency-matched by age. Bone status was assessed by DXA (lumbar spine, femoral neck) and distal radius pQCT. Serum levels of routine bone and mineral metabolism markers, alongside a targeted panel of osteoimmunological mediators (OPG, OPN, PDGF-BB, ACP5, RANKL, TNF-α, IL-6, IL-1β, DKK-1) using multiplex immunoassay were measured. FRAX scores were calculated to contextualize clinical fracture risk. With broadly comparable DXA-defined bone status, pQCT revealed significantly lower trabecular volumetric bone mineral density (vBMD) in SSc, while total and cortical+subcortical vBMD were comparable. Routine biochemical markers showed substantial overlap between groups, whereas SSc patients exhibited a distinct osteoimmune profile with significantly elevated OPG, ACP5, RANKL, PDGF-BB, IL-6, IL-1β, DKK-1, and RANKL/OPG after FDR correction. Exploratory biomarker-bone associations did not remain significant after correction for multiple testing. In women with relatively early SSc, pQCT identified compartment-specific differences, particularly within the trabecular compartment, despite comparable DXA-defined bone status. A distinct osteoimmunological biomarker profile was also observed in SSc, providing complementary information on disease-related skeletal alterations, while specific biomarker-bone associations require further confirmation.
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