Progressive vertebral deformities despite unchanged bone mineral density in patients with sarcoidosis: a 4-year follow-up study.
To evaluate the incidence of new and/or progressive vertebral deformities and changes in bone mineral density, we re-examined 66 patients with sarcoidosis after a follow-up period of four years. In 17 subjects (26%) new and/or progressive vertebral deformities were found, though BMD did not change significantly.


BACKGROUND
Previous studies from our group have shown that morphometric vertebral deformities suggestive of fractures can be found in 20% of patients with sarcoidosis, despite a normal bone mineral density (BMD). The aim of this study was to determine the incidence of new and/or progressive vertebral deformities and the evolution of BMD during the course of this disease.


METHODS
BMD of the hip (DXA) and vertebral fracture assessment (VFA) with lateral single energy densitometry was performed at baseline and after 45 months in 66 patients with sarcoidosis. Potential predictors of new/ progressive vertebral deformities were assessed using logistic regression analysis.


RESULTS
The BMD of the total group was unchanged after follow-up. The prevalence of vertebral deformities increased from 20 to 32% (p < 0.05); in 17 subjects (26%) new or progressive vertebral deformities were diagnosed. A lower T-score of the femoral neck [(OR = 2.5 (CI: 1.0-5.9), p < 0.05)] and mother with a hip fracture [(OR = 14.1 (CI: 1.4-142.6), p < 0.05)] were independent predictors of new/progressive deformities.


CONCLUSIONS
In subjects with sarcoidosis the number of vertebral deformities increases in the course of this disease, despite unchanged BMD. The combination of low normal BMD and family history of fragility fractures confers an increased risk of the incidence of these deformities.
Heijckmann
A C
AC
Department of Internal Medicine, Division of Endocrinology, University Hospital Maastricht, Maastricht, The Netherlands. caroline@heesen.eu
Drent
M
M
Dumitrescu
B
B
De Vries
J
J
Nieuwenhuijzen Kruseman
A C
AC
Wolffenbuttel
B H R
BH
Geusens
P
P
Huijberts
M S P
MS
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D016723:Bone Remodeling; D018450:Disease Progression; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006620:Hip Fractures / Q000235:genetics; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012507:Sarcoidosis / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index; D013121:Spinal Curvatures / Q000209:etiology* / Q000503:physiopathology; D016103:Spinal Fractures / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult