{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:06Z","timestamp":1787028666964,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Systemic sclerosis (SSc) patients frequently develop osteoporosis; however, vertebral fracture risk factors remain poorly characterized. This study identifies general and SSc-specific predictors of vertebral fractures in SSc patients undergoing osteoporosis evaluation. Methods: This multicenter cross-sectional study enrolled consecutive SSc patients meeting ACR\/EULAR 2013 criteria with suspected osteoporosis. Data included demographics, disease characteristics, bone density (DXA), and vertebral imaging. Stepwise logistic regression analyzed fracture associations (p \u2264 0.05 significant). Results: The majority of 103 enrolled patients were female and all were post-menopausal. The prevalence of osteoporosis was 52.4%, that of vertebral fractures was 38.8%, and that of osteopenia was 28.1%. General risk factor analysis identified family history of fragility fractures (OR 11.8, p = 0.008) and vertebral T-scores (OR 0.6, p = 0.049) as significant predictors. When adding SSc-specific factors, only family history (OR 13.8, p = 0.03) and gastrointestinal (GI) involvement (OR 4.8, p = 0.05) remained significant. Conclusions: Vertebral fractures in SSc patients are strongly linked to a family history of fractures. The suggestive association with GI involvement may imply a significant role for malabsorption-related metabolic impairment. Prioritizing bone density screening in SSc patients with GI symptoms may enable earlier intervention and reduce fracture risk.<\/jats:p>","DOI":"10.3390\/jcm15051794","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:41:02Z","timestamp":1772188862000},"page":"1794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring Disease-Specific Risk Factors for Vertebral Fractures in Systemic Sclerosis: Insights from the ScleroRER Study Group"],"prefix":"10.3390","volume":"15","author":[{"given":"Alessandra","family":"Bezzi","sequence":"first","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, Ospedale \u201cInfermi di Rimini\u201d, 47923 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Lumetti","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy"},{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Mascella","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, Ospedale \u201cInfermi di Rimini\u201d, 47923 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Focherini","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, Ospedale \u201cInfermi di Rimini\u201d, 47923 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Arrigoni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Hospital Guglielmo da Saliceto, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bravi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Hospital Guglielmo da Saliceto, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lo Monaco","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical Sciences, Rheumatology, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Spinella","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4954-9728","authenticated-orcid":false,"given":"Ottavio","family":"Secchi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Bajocchi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Arcispedale Santa Maria Nuova, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Girelli","sequence":"additional","affiliation":[{"name":"Internal Medicine, Ospedale \u201cMorgagni-Pierantoni\u201d di Forl\u00ec, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ursini","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum Universit\u00e0 di Bologna, 40123 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Cataleta","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine, Hospital Santa Maria delle Croci, AUSL-Romagna, 48121 Ravenna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Reta","sequence":"additional","affiliation":[{"name":"Rheumatology & Internal Medicine Unit, Carlo Alberto Pizzardi Hospital-AUSL Bologna, Policlinico di Sant\u2019Orsola IRCCS University Hosptal of Bologna, 40138 Bologna, 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