Series Researches Of Association Between Systemic Sclerosis And Bone Mineral Density, Pulmonary Hypertension, And Vitamin D

Objective This study aims to review the clinical and laboratory profiles of systemic sclerosis(SSc) patients with and without echocardiographically detected pulmonary hypertension(PH) in China.Methods The study included 136 consecutive patients treated from 1992 to 2012. Diagnosis of SSc was made according to the 1980 revision of the American College of Rheumatology SSc criteria. PH was defined as systolic pulmonary artery pressure ≥ 40 mm Hg detected by Doppler echocardiography. The clinical and laboratory parameters of SSc patients with pulmonary hypertension(SSc-PH) were compared to those of SSc patients without pulmonary hypertension(SSc-no PH).Results Of the 136 SSc patients, 28(20.6%) were diagnosed as having PH by echocardiography. Upon comparison with the SSc no?PH patients, SSc-PH patients were objective of this study was to perform a meta-analysis to investigate the differences in bone mineral density(BMD) between Systemic sclerosis(SSc) and non-SSc control and to discuss potential served to have a significantly higher frequency of subjective dyspnea(P = 0.010) and a higher rate of anti-nuclear RNP(anti-n RNP) antibody positivity(P = 0.028). We also observed that the percentage of SSc-PH patients with increased urea nitrogen is significantly higher than that of SSc-no PH patients after correction for multiple testing(P = 0.006, compared to patients with normal values).Conclusion The prevalence of PH was 20.6% in patients with SSc by echocardiography. The clinical and laboratory features vary between in SSc patients with and without PH detected by echocardiography. SSc with PH correlated with subjective dyspnea, the positive of anti-n RNP antibody and increased urea nitrogen.Objective The objective of this study was to perform a systematic review to investigate the differences in bone mineral density(BMD)(g/cm2) between Systemic sclerosis(SSc) and non-SSc control and to discuss potential underlying risk.Methods We searched research articles from Pub Med literature database which measure BMD at the lumbar spine, total hip or femoral neck by dual energy X-ray absorptiometry prior to February, 2015. search terms were ‘Systemic sclerosis’ OR ‘scleroderma’ and ‘osteoporosis’ OR ‘bone density’ OR ‘bone mass’.Results Out of the 12 studies, seven were case-control studies and five were cross-sectional studies. The population sources of the studies were Africa(one study), Europe(five studies), the Americas(five studies) and Asia(one study). The combined results showed that the difference of BMD in patients with SSc and control group was statistically significant at lumbar spine(weighted mean difference-0.099, 95% confidence interval-0.128 to-0.069, P < 0.001), femoral neck(weighted mean difference-0.110, 95% confidence interval-0.149 to-0.072, P < 0.001) and total hip(weighted mean difference-0.75, 95% confidence interval-0.097 to-0.054 difference, P < 0.001).Conclusion BMD may be lower in SSc patients with than that in healthy control group. The possible risk of lower BMD could be BMI, the severity of disease(organ involvement and diffuse form), inflammation(IL-1β, IL-6, TNF-α and CRP) and menopause(duration of menopause and early age of menopause).Objective Epidemiological and medical characteristics of serum level of vitamin D measured in systemic sclerosis(SSc) patients and healthy control.Methods 25-Hydroxy vitamin D 125 I RIA kit was applied to compare the difference in the serum level of vitamin D between 60 SSc patients from Anhui Provincial Hospital and 60 healthy control. SSc patients was separated into two groups based on serum vitamin D deficiency to analyzing the epidemiological and clinical characteristics of SSc patients with serum vitamin D deficiency.Results The serum level of vitamin D is significantly lower in SSc patients than that in healthy control(26.51 ± 6.29 VS 36.29 ± 14.24 ng/ml, P < 0.001). The proportion of serum vitamin D deficiency in patients was significantly higher than that in the control group(75.0% VS 35.0%, P = 0.003)., the ratio of interstitial lung disease(interstitial pneumonia pulmonary or pulmonary interstitial change) was significantly higher in SSc patients with serum vitamin D deficiency than that with serum vitamin D normal(P = 0.037), while the difference of other aspects, such as duration of the disease, body mass index, menopausal status, use of glucocorticoid drugs, exposure to ultraviolet, menarche, first symptoms and serology results, was no statistically significant in the two groups.Conclusion Both serum vitamin D level and the ratio of serum vitamin D normal were lower than that in healthy control group. SSc patients with low serum vitamin D levels may be associated with the interstitial lung disease(interstitial pneumonia pulmonary or pulmonary interstitial change).