Dual-Energy X-Ray Absorptiometry Screening and Factors Associated with Osteoporosis in a Real-World Turkish Systemic Sclerosis Cohort

Objective: Fibrosis and vasculopathy are the hallmark features of systemic sclerosis (SSc); yet, osteoporosis, as in other chronic inflammatory rheumatic diseases, also represents a significant source of morbidity in SSc. The proportion of dual-energy X-ray absorptiometry (DXA) screening in an SSc cohort was reported, and the frequency of osteoporosis and associated factors among patients who underwent DXA was evaluated.Methods: A total of 231 patients with SSc were retrospectively assessed for eligibility. After exclusions, the final cohort comprised 208 patients and was evaluated to determine the proportion undergoing DXA and the factors associated with DXA assessment. The frequency of osteoporosis and associated factors were evaluated separately among patients who underwent DXA.Results: Among the final SSc cohort (n = 208), 84 patients (40.4%) underwent DXA. Among the DXA subgroup (n = 84), osteoporosis was identified in 29 patients (34.5%). In univariable analyses within this subgroup, lower body mass index (BMI) and prior glucocorticoid exposure were associated with osteoporosis, whereas anti-centromere antibody positivity was associated with lower odds of osteoporosis. In the exploratory multivariable analysis, lower BMI and postmenopausal status remained associated with osteoporosis. In the entire cohort, older age, overlap subtype, and longer disease duration remained associated with undergoing DXA after adjustment.Conclusion: Osteoporosis was frequent among the clinically selected subgroup of patients who underwent DXA; however, this finding should not be interpreted as the prevalence of osteoporosis in the overall SSc cohort.