Prevalence and factors associated with osteoporosis and fragility fractures in patients with primary Sjögren syndrome

Abstract

This study aimed at determining socio-demographic and clinical factors of primary Sjögren syndrome (pSS) associated with osteoporosis (OP) and fragility fracture. SJOGRENSER is a cross-sectional study of patients with pSS, classified according to American European consensus criteria developed in 33 Spanish rheumatology departments. Epidemiological, clinical, serological and treatment data were collected and a descriptive analysis was conducted. Bivariate and multivariate analyses were performed using a binomial logistic regression to study the factors associated with OP and fragility fracture in pSS. 437 patients were included (95% women, with a median age of 58.6 years). 300 women were menopausal (76.4%). Prevalence of OP was 18.5% [in men (N = 21) this measured 19%]. A total of 37 fragility fractures were recorded. In the multivariate analysis, there was an association between OP and age: in the 51–64 age range (menopausal women), the OR measured 9.993 (95% CI 2301–43,399, p = 0.002); In the age > 64 years group, OR was 20.610 (4.679–90.774, p < 0.001); between OP and disease duration, OR was 1.046 (1.008–1085, p = 0.017); past treatment with corticosteroids, OR 2.548 (1.271–5.105, p = 0.008). Similarly, an association was found between fragility fractures and age: in the 51–64 age group, OR measured 5.068 (1.117–22,995, p = 0.035), age > 64 years, OR was 7.674 (1.675–35,151, p < 0.009); disease duration, OR 1.049 (CI 1.003–1097, p < 0.036) and the ESSDAI index, OR 1.080 (1.029–1134, p = 0.002). Patients with pSS can develop osteoporosis and fragility fractures over the course of the disease. Age, corticosteroids treatment and disease duration were associated with the development of OP. Disease duration and ESSDAI were associated with the development of fractures in patients with pSS.

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Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Tarek Carlos Salman-Monte.

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Co-investigators

Antonio Naranjo. Hospital de Gran Canaria Doctor Negrín, Iñigo Rúa-Figueroa. Hospital de Gran Canaria Doctor Negrín, Marina Rodríguez López. Hospital de Meixoeiro, Vigo, Coral Mouriño. Hospital de Meixoeiro, Vigo, Óscar Illera. Hospital Infanta Sofía, Madrid, Lurdes Romani. Hospital Virgen de las Nieves, Granada.

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Salman-Monte, T.C., Sanchez-Piedra, C., Fernandez Castro, M. et al. Prevalence and factors associated with osteoporosis and fragility fractures in patients with primary Sjögren syndrome. Rheumatol Int 40, 1259–1265 (2020). https://doi.org/10.1007/s00296-020-04615-3

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Keywords

  • Sjögren syndrome
  • Osteoporosis
  • Osteoporotic fractures
  • Bone remodeling