Background/Purpose:  Primary Sjogren’s syndrome (pSS) is a chronic rheumatic disease. The long-term use of drugs and its renal involvement may contribute to low bone mineral density (BMD). Our objective was to investigate the state of bone health in patients with pSS.

Methods:  Patients were all Chinese from the outpatient and inpatient clinic of our hospital (Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China). Primary SS was defined according to the revised American-European classification criteria. Each patient had BMD measurement by dual energy x-ray absorptiometry. Diagnoses of osteopenia and osteoporosis were made using calculations based on the World Health Organization T-score (or Z-score in premenopausal women and men younger than 50) criteria (−1.0 to −2.5 SD was osteopenia and ≤−2.5 SD was osteoporosis). Their demographic and clinical features were recorded and analyzed whether they had impact on the results of BMD.

Results:  Totally, 128 Chinese patients (male: female=19:109) were studied. 23 of them were premenopausal and the other 86 were postmenopausal. Their ages were 53.2±8.7 years old and their disease durations were 5.6±4.9 years. The serum levels of calcium and phosphorus of most of them were normal (except 3 had hypocalcemia). Their urinary pH were >5.5. Their mean T (or Z) scores of lumbar spine were -2.1±1.3, of femoral neck were -1.7±1.5, and of total hip were -1.1±1.8. 20 (15.6%) patients were with normal BMD results, 42 (32.8%) were osteopenia, and 66 (51.6%) were osteoporosis. 6 patients had history of pathological fracture. The prevalence of impaired bone health (both osteopenia osteoporosis) was significantly higher in postmenopausal than in premenopausal women (39.5% vs. 26.1%, p<0.05). BMD results were not correlated with disease duration, the serum levels of calcium and phosphorus, and the usage of glucocorticoids (all p>0.05), but significantly correlated with the age negatively (p<0.01).

Conclusion:  The prevalence of osteopenia or osteoporosis was high in patients with primary Sjogren’s syndrome and it was not due to the usage of glucocorticoids.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impaired-bone-health-in-patients-with-primary-sjogrens-syndrome/