Department of Neurology, University Hospital of North Norway, P.O. Box 33, 9038, Tromsø, Norway.
J Neurol. 2010 Mar;257(3):410-8. doi: 10.1007/s00415-009-5337-6. Epub 2009 Oct 1.
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 < 0.001) and age (beta = -0.004; 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 < or = -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.
多发性硬化症（MS）对骨骼健康的影响尚未完全阐明。本项基于人群的研究旨在确定与 50 岁以下完全活动的 MS 患者的骨量相关的过去和当前的暴露因素，并确定该组患者中低骨密度（BMD）的患病率。我们测量了 55 名女性和 25 名男性 MS 患者的 BMD（髋部、腰椎、前臂）、身体功能、BMI 和血清 25（OH）维生素 D。患者提供了人口统计学变量和病史、过去和当前的维生素 D 和钙摄入量、身体活动以及生活方式习惯的信息。在回归分析中，BMD 水平根据年龄、性别和 BMI 进行了调整。在股骨颈处，行走距离（β=0.152；P＜0.001）和年龄（β=-0.004；P=0.003）与 BMD 呈强相关，而男性（β=0.055；P=0.014）和 10 英尺计时并足走（β=-0.008；P=0.013）与 BMD 的相关性不太确定。在腰椎处，行走距离（β=0.013；P=0.006）和可能的青少年时期身体活动（β=0.035；P=0.028）以及男性（β=-0.057；P=0.042）与 BMD 相关。在桡骨远端，握力（β=0.001；P=0.002）与 BMD 相关，而不太确定的是，16-20 岁时的夏季户外活动（β=0.021；P=0.009）和 MS 发病年龄（β=0.002；P=0.036）与 BMD 相关。80 名患者中有 19 名存在低 BMD（z 评分＜或=-2）。本研究表明，MS 相关的变量以及过去的暴露因素对三个重要的骨骼部位的 BMD 有不同的影响。这些年轻患者中低 BMD 较为常见。MS 患者的骨骼健康应受到关注。
