Ultrasonic densitometry of the calcaneus in patients with rheumatic diseases

Abstract

Introduction. Studies show a high prevalence of periodontal disease among patients with various rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus (SLE), psoriatic arthritis, and Sjögren's syndrome [1]. Periodontal disease, characterized by inflammation and destruction of the tissues that support the teeth, may be associated with the duration of rheumatic disease as well as with drug treatment with corticosteroids. Glucocorticoids (GC) are the main drugs in rheumatology, widely used due to their powerful antiinflammatory and immunosuppressive properties [2]. However, their long-term use is a well-established cause of secondary osteoporosis, known as glucocorticoid-induced osteoporosis, a general loss of bone mineral density (BMD) [3]. Overall bone density loss is also a key indicator of periodontitis severity and affects the further prognosis of treatment [4]. The aim of the study was to evaluate age-appropriate heel bone density indicators in rheumatic patients depending on the severity of periodontal disease. Materials and methods. The study involved 35 patients (7 men and 28 women) aged 25 to 57 years (mean age 34.3 years). All patients were treated in the rheumatology department of the A. Novak ZOR Regional Clinical Hospital. Results. All patients had below-normal indicators. The 35 people who participated in the study had low bone density, indicating osteopenia and, in some cases, osteoporosis. The average indicator for patients was -2.27 in group I and -1.77 in group II. Patients with SLE are more likely to develop periodontitis and have an increased risk of bone thinning. In our opinion, this is associated with long-term use of GCs, which in turn inhibits the formation of new bone tissue and increases its destruction, which significantly affects secondary osteoporosis. Conclusions. The lowest BMD values among rheumatic diseases were found in patients with SLE: -2.43. The lower the BMD values in patients with rheumatic diseases, the more severe the periodontitis.