P102 | Sarcoidosis and Osteoporosis: Association with Disease Severity

C. Mondillo¹, A. Al Refaie¹, A. Versienti¹, G. Manasse¹, P. Cameli², E. Bargagli², S. Gonnelli¹, L. Gennari¹, C. Caffarelli¹ | ¹UOC Medicina Interna e della Complessità, Dipartimento di Scienze mediche, Chirurgiche e Neuroscienze, Università di Siena, ²UOC Malattie Respiratorie e Trapianto Polmonare, Dipartimento di Scienze mediche, Chirurgiche e Neuroscienze, Università di Siena, Italy

Abstract

Background and Study Purpose: Sarcoidosis is characterized by a chronic inflammatory state, vitamin D deficiency, and corticosteroid use, all of which contribute to a decrease in bone mineral density (BMD) and a subsequent increase in fractures. The aim of the study was to evaluate the prevalence and risk factors for fractures in patients with sarcoidosis.
Materials and Methods: In 382 patients (55.8±11.6 years old), we evaluated BMD, respiratory function tests including carbon monoxide diffusion capacity (DLCO), and lung parenchyma involvement thru radiological staging using the Scadding score.
Results: 90 patients (23.6%) had reported a fracture. BMD values were found to be positively correlated with DLCO (%) (p<0.001). The prevalence of fractures was found to be higher in subjects with greater pulmonary involvement (Scadding score 2-4) compared to those with less pulmonary parenchymal compromise (Scadding score 0-1) (28.3% vs. 19.2% respectively, p<0.05). Multiple regression analysis showed that fractures are positively associated with lung parenchyma involvement, while BMD values and therapy are negatively associated with fractures.
Conclusions: Fractures are a frequent and significant complication in patients with moderate/severe sarcoidosis. Therefore, a radiological assessment and DLCO could help define the risk of fractures and implement early therapeutic strategies.