25OHD serum levels are below the lower limit of normal range levels (30 ng/ml, dotted line) both in healthy subjects and the two cutaneous subsets of SSc.

<p>Nevertheless in healthy subjects the observed 25OHD circulating levels are significantly higher compared to both lcSSc and dcSSc; furthermore, in patients with dcSSc, 25OHD levels are significantly lower compared to the limited cutaneous form. *p<0,01; **p<0,001.</p

Relationship between the degree of skin fibrosis assessed by modified Rodnan skin score and PTH serum levels in SSc patients.

<p>There is no relationship between PTH serum levels and Rodnan skin score, although a tendency to a direct correlation was observed, which did not reach statistical significance.</p

Demographic and clinical characteristics of SSc patients and healthy controls.

<p>* Years from the onset of the first sign/symptom of diseased other than Raynaud phenomenon</p><p>Demographic and clinical characteristics of SSc patients and healthy controls.</p

Relationship between Body Mass Composition, Bone Mineral Density, Skin Fibrosis and 25(OH) Vitamin D Serum Levels in Systemic Sclerosis

<div><p>A reduced bone mineral density (BMD) is observed in several rheumatic autoimmune diseases, including Systemic Sclerosis (SSc); nevertheless, data concerning the possible determinants of bone loss in this disease are not fully investigated. The aim of this study is to evaluate the relationship between BMD, body mass composition, skin sclerosis and serum Vitamin D levels in two subsets of SSc patients. 64 post-menopausal SSc patients, classified as limited cutaneous (lcSSc) or diffuse cutaneous (dcSSc) SSc, were studied. As control, 35 healthy post-menopausal women were recruited. Clinical parameters were evaluated, including the extent of skin involvement. BMD at lumbar spine, hip, femoral neck and body mass composition were determined by dual-energy X-ray absorptiometry. Serum calcium, phosphorus, alkaline phosphatase, urine pyridinium cross-links, intact parathyroid hormone and 25-hydroxyvitamin D (25OHD) were measured. BMD at spine, femoral neck and total hip was significantly lower in SSc patients compared to controls. In dcSSc subset, BMD at spine, femoral neck and total hip was significantly lower compared to lcSSc. No differences in both fat and lean mass were found in the three study groups even if patients with dcSSc showed a slightly lower total body mass compared to healthy controls. Total mineral content was significantly reduced in dSSc compared to both healthy subjects and lcSSc group. Hypovitaminosis D was observed both in healthy post-menopausal women and in SSc patients, but 25OHD levels were significantly lower in dcSSc compared to lcSSc and inversely correlated with the extent of skin thickness. These results support the hypothesis that the extent of skin involvement in SSc patients could be an important factor in determining low circulating levels of 25OHD, which in turn could play a significant role in the reduction of BMD and total mineral content.</p></div

Relationship between the degree of skin fibrosis assessed by modified Rodnan skin score and 25OHD levels in SSc patients.

<p>A significant inverse relationship between the degree of skin fibrosis and circulating levels of 25OHD (r = -0,7, p<0,05).</p

T-scores values and prevalence of osteoporosis and osteopenia in healthy controls and SSc patients.

<p>T-scores values and prevalence of osteoporosis and osteopenia in healthy controls and SSc patients.</p

BMD values at spine, femoral neck and total hip in healthy post-menopausal women and patients with limited and diffuse SSc.

<p>BMD at spine and total hip is significantly lower in dcSSc patients compared to both healthy subjects and lSSc patients. No significant difference between healthy subjects and lcSSc patients is observed. At femoral neck BMD was significantly lower both in dcSSc and lcSSc patients compared to healthy subjects. Both at spine, total hip and femoral neck, BMD was significantly lower in dcSSc patients compared to lcSSc patients *p<0,001; **p<0,01.</p

Analysis of body mass composition in healthy post-menopausal women and patients with diffuse and limited SSc subsets (fat, lean and total mass and total mineral content).

<p><b>2A.</b> No differences in fat mass and lean mass are observed between healthy control group, limited and diffuse cutaneous subsets of SSc; total body mass was significantly lower in dcSSc patients compared to healthy controls (*p<0,05). Patients with dcSSc also show a slightly lower total body mass compared to lcSSc which do not reach statistical significance. <b>2B.</b> No difference in total mineral content is observed between healthy subjects and lcSSc patients, whereas total mineral content was significantly lower in dcSSc compared to both control group (*p<0,001) and lcSSc group (**p<0,01).</p