Kampman M T, Eriksen E F, Holmøy T
Centre for Clinical Research and Education, University Hospital of North Norway, Tromsø, Norway.
Acta Neurol Scand Suppl. 2011(191):44-9. doi: 10.1111/j.1600-0404.2011.01543.x.
Both women and men with multiple sclerosis (MS) are at increased risk of developing osteoporosis.
A non-systematic review of the prevalence,pathogenesis and treatment of osteoporosis in patients with multiple sclerosis.
MS and osteoporosis share aetiological risk factors such as smoking and hypovitaminosis D, as well as pathogenetic players such as osteopontin and osteoprotegerin. Recently, low bone mineral density (BMD) values have been measured shortly after diagnosis of clinically isolated syndrome and MS and in fully ambulatory persons with MS below 50 years of age. Studies consistently show that BMD at the femoral neck decreases with increasing MS-related disability. Osteoporosis-related fractures cause increased morbidity and mortality and add to the burden of having MS.
We argue that MS, like a number of other chronic diseases, is a cause of secondary osteoporosis. Therefore, bone health assessment should be a part of the integral management of persons with MS. We suggest that BMD be measured shortly after diagnosis, that BMD measurements be repeated depending on BMD values and individual osteoporosis risk profile, and that serum 25-hydroxyvitamin D be monitored. All persons with MS should receive bone health advice.
患有多发性硬化症（MS）的女性和男性患骨质疏松症的风险均会增加。
对多发性硬化症患者骨质疏松症的患病率、发病机制及治疗进行非系统性综述。
MS和骨质疏松症有共同的病因风险因素，如吸烟和维生素D缺乏，以及共同的发病相关因素，如骨桥蛋白和骨保护素。最近，在临床孤立综合征和MS诊断后不久，以及在50岁以下完全能行走的MS患者中，均检测到了低骨密度（BMD）值。研究一致表明，股骨颈的BMD会随着与MS相关的残疾程度增加而降低。与骨质疏松症相关的骨折会导致发病率和死亡率上升，并加重患MS的负担。
我们认为，MS与许多其他慢性疾病一样，是继发性骨质疏松症的一个病因。因此，骨骼健康评估应成为MS患者综合管理的一部分。我们建议在诊断后不久测量BMD，根据BMD值和个体骨质疏松症风险状况重复进行BMD测量，并监测血清25-羟维生素D。所有MS患者都应接受骨骼健康建议。
