Higher fracture prevalence and smaller bone size in patients with hEDS/HSD—a prospective cohort study
- 24.12.2019
- Original Article
Erschienen in:
- Verfasst von
- T. Banica
- M. Coussens
- C. Verroken
- P. Calders
- I. De Wandele
- F. Malfait
- H.-G. Zmierczak
- S. Goemaere
- B. Lapauw
- L. Rombaut
- Erschienen in
- Osteoporosis International | Ausgabe 5/2020
Abstract
Summary
Increased fracture risk in patients with Ehlers-Danlos syndromes has been reported, but the reasons for it are incompletely understood. We aimed to investigate possible determinants of this increased risk and found that hEDS/HSD patients present with a cortical bone size deficit compared with control subjects, possibly related to lower mechanical loading.
Introduction
The Ehlers-Danlos syndromes (EDS) comprise a group of heritable connective tissue disorders caused by defects in the biosynthesis, secretion, and/or organization of fibrillar collagens which might impair bone strength. Our aim was to compare fracture prevalence, volumetric and areal bone mineral density (BMD), bone geometry, muscle size and the muscle-bone interaction, body composition and longitudinal changes therein between patients with hypermobile EDS (hEDS) or hypermobility spectrum disorder (HSD), and healthy control subjects.
Methods
Cross-sectional data comprised 39 female hEDS/HSD patients (age 41 ± 11 years) and 43 age-matched controls. After 8 years, 27 hEDS/HSD and 17 control subjects were re-evaluated. Tibial trabecular and cortical volumetric BMD, bone mineral content (BMC), cortical bone geometry, and lower leg muscle cross-sectional area (CSA) were measured using pQCT. Body composition, areal BMD, and BMC were determined by DXA.
Results
At baseline, patients with hEDS/HSD presented with a smaller cortical bone area, smaller cortical thickness and muscle CSA, and a higher fracture prevalence than control subjects (all p < 0.05). No differences in areal or volumetric BMD were found. Longitudinally, muscle CSA decreased in both groups and muscle density decreased in the hEDS/HSD group (p < 0.001) whereas all bone parameters remained unchanged.
Conclusion
hEDS/HSD patients have a cortical bone size deficit compared with controls, possibly contributing to their increased fracture risk. They presented with decreased muscle CSA but normal bone/muscle area ratio, suggesting that this bone size deficit is likely secondary to decreased mechanical loading. Further, there were no arguments for accelerated bone loss in hEDS/HSD subjects.
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- Titel
- Higher fracture prevalence and smaller bone size in patients with hEDS/HSD—a prospective cohort study
- Verfasst von
-
T. Banica
M. Coussens
C. Verroken
P. Calders
I. De Wandele
F. Malfait
H.-G. Zmierczak
S. Goemaere
B. Lapauw
L. Rombaut
- Publikationsdatum
- 24.12.2019
- Verlag
- Springer London
- Erschienen in
-
Osteoporosis International / Ausgabe 5/2020
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965 - DOI
- https://doi.org/10.1007/s00198-019-05269-z
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