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Lumbar spine and femoral neck bone mineral density (BMD) was assessed by DXA. Volumetric BMD was measured by pQCT at the radius. FRAX, 25-hydroxyvitamin-D\n                      <jats:sub>3<\/jats:sub>\n                      (25-OH-D\n                      <jats:sub>3<\/jats:sub>\n                      ), parathyroid hormone, osteocalcin, C-terminal collagen telopeptide, and procollagen type I amino-terminal propeptide were also assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SSc patients had lower L2\u20134 BMD (0.880\u2009\u00b1\u20090.108 vs. 0.996\u2009\u00b1\u20090.181\u2009g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) and femoral neck (FN) BMD (0.786\u2009\u00b1\u20090.134 vs. 0.910\u2009\u00b1\u20090.090\u2009g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) by DXA. In SSc vs. controls, pQCT indicated lower mean cortical (328.03\u2009\u00b1\u2009103.32 vs. 487.06\u2009\u00b1\u200942.45\u2009mg\/cm\n                      <jats:sup>3<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and trabecular density (150.93\u2009\u00b1\u200961.91 vs. 184.76\u2009\u00b1\u200933.03\u2009mg\/cm\n                      <jats:sup>3<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Vitamin D\n                      <jats:sub>3<\/jats:sub>\n                      deficiency was more common in SSc vs. controls (60.0% vs. 39.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). L2\u20134 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and FN BMD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) positively correlated with BMI. pQCT assessments confirmed an inverse correlation between pulmonary manifestation and total (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), trabecular (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), and cortical density (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Anti-Scl70 positivity inversely correlated with pQCT total density (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) and the presence of digital ulcers with cortical density (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). We also found that vertebral and FN BMD as determined by DXA significantly correlated with pQCT total, trabecular, and cortical density (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of our study suggest that bone loss in SSc patients may be associated with lower BMI, anti-Scl70 positivity, and the presence of pulmonary manifestations and digital ulcers. Both DXA and pQCT are appropriate tools to evaluate the bone alterations in SSc patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-019-2072-y","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T08:03:52Z","timestamp":1575965032000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Complex assessment of bone mineral density, fracture risk, vitamin D status, and bone metabolism in Hungarian systemic sclerosis patients"],"prefix":"10.1186","volume":"21","author":[{"given":"\u00c1gnes","family":"Horv\u00e1th","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit","family":"V\u00e9gh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Pusztai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zs\u00f3fia","family":"Peth\u0151","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Hamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Cz\u00f3kolyov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harjit Pal","family":"Bhattoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Nagy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs","family":"Juh\u00e1sz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Hodosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Domj\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Szekanecz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Sz\u00fccs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szilvia","family":"Szamosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"2072_CR1","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1056\/NEJMra0806188","volume":"360","author":"A Gabrielli","year":"2009","unstructured":"Gabrielli A, Avvedimento EV, Krieg T. 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Rheumatology (Oxford). 2013;52:296\u2013303.","journal-title":"Rheumatology (Oxford)"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-019-2072-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13075-019-2072-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-019-2072-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T20:52:03Z","timestamp":1607460723000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/s13075-019-2072-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["2072"],"URL":"https:\/\/doi.org\/10.1186\/s13075-019-2072-y","relation":{},"ISSN":["1478-6362"],"issn-type":[{"value":"1478-6362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"16 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Hungarian Scientific Research Council Ethical Committee (approval No. 14804-2\/2011\/EKU). Written informed consent was obtained from each patient, and assessments were carried out according to the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"274"}}