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Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis

Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis,10.1007/s00415-009-5337-6,Journal of Neurolo

Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis   (Citations: 7)
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The implications of having multiple sclerosis (MS) for bone health are incompletely understood. The aim of this population-based study is to identify past and current exposures that are associated with bone mass in fully ambulatory persons with MS up to age 50 years and to determine the prevalence of low bone mineral density (BMD) in this group. We measured BMD (hips, lumbar spine, forearms), physical function, BMI, and serum 25(OH) vitamin D in 55 women and 25 men with MS. Patients provided information on demographic variables and medical history, as well as past and current vitamin D and calcium intake, physical activity, and lifestyle habits. In regression analyses, BMD levels were adjusted for age, sex, and BMI. At the femoral neck, strong associations were found for walking distance (beta = 0.152; P P = 0.003), and less certain associations for male sex (beta = 0.055; P = 0.014) and 10-foot timed tandem walk (−0.008; P = 0.013). At the lumbar spine, walking distance (beta = 0.013; P = 0.006) and possibly physical activity growing up (beta = 0.035; P = 0.028) and male sex (beta = −0.057; P = 0.042), were associated with BMD. At the ultradistal radius, strength of grip (beta = 0.001; P = 0.002), and, less certainly, summer outdoor activities age 16–20 (beta = 0.021; P = 0.009), and age at MS onset (beta = 0.002; P = 0.036) were associated with BMD. Low BMD (z score ≤−2) was present in 19 out of 80 patients. This study shows that MS-related variables as well as past exposures differentially affect BMD at three clinically important skeletal sites. Low BMD is prevalent in these young patients. Bone health should receive attention in care for persons with MS.
Journal: Journal of Neurology - J NEUROL , vol. 257, no. 3, pp. 410-418, 2010
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    • ...In persons with MS, low bone mineral density (BMD) is more prevalent when compared with controls [10, 27, 37, 38] and with reference databases [26, 35, 39]...
    • ...Baseline data from this study showed that one out of four participants had lower than expected BMD for sex and age [35]...
    • ...At baseline, one quarter of our study population had lower than expected BMD for sex and age [35]...

    Linn H. Steffensenet al. Can vitamin D 3 supplementation prevent bone loss in persons with MS? ...

    • ...In another study, Steffensen et al. [16] reported Z scores below -2.0 at least at one of the nine studied skeletal sites with DXA in 32% of the studied 25 male patients of mean age of 42 years and EDSS \ 5.0...
    • ...Similarly, Steffensen et al. [16] failed to find BMD alternations at the lumbar spine, femoral neck, and the non-dominant ultradistal radius in a group of 55 premenopausal patients with EDSS less than 5.5...
    • ...Among others, reduced physical activity [6], 16, glucocorticoid use [6, 9, 10, 13, 17–19, 21, 22] or vitamin D deficiency [8, 10, 14, 16, 21, 23, 24] were studied as potential predisposing factors for osteoporosis...

    Chrissa Siokaet al. Bone mineral density in ambulatory patients with multiple sclerosis

    • ...Only one randomised control trial was identified [3]...
    • ...Steffensen et al. [53] Z-score ≤−2 in 24%...
    • ...In the intervention group, 92% of the patients achieved a 25-OHD level >75 nmol/L compared with 30% of the placebo group [3]...

    J. C. Gibsonet al. Bone health in multiple sclerosis

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