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多发性硬化症患者低骨密度的患病率及危险因素

Prevalence and risk factors of low bone mineral density in patients with multiple sclerosis.

作者信息

Coskun Benlidayi I, Basaran S, Evlice A, Erdem M, Demirkiran M

出版信息

Acta Clin Belg. 2015 Jun;70(3):188-92. doi: 10.1179/2295333715Y.0000000002.

DOI:10.1179/2295333715Y.0000000002
PMID:26103537
Abstract

OBJECTIVES

To determine the prevalence and risk factors of low bone mineral density (BMD) in patients with multiple sclerosis (MS).

METHODS

Patients with MS who had undergone a BMD evaluation via dual-energy X-ray absorptiometry (DXA) between January 2010 and December 2013 were included in the study. Descriptive data, BMD values, and risk factors for osteoporosis along with the details regarding MS, such as age at onset, duration of disease, clinical type of MS, expanded disability status scale (EDSS) scores, and lifetime steroid intake were obtained from the medical record database and telephone interview.

RESULTS

The study group comprised 67 patients with a mean age of 41.1 ± 10.2 years. Of the patients, 20.9% revealed low BMD for chronological age. Vitamin D insufficiency (25(OH)D < 20  ng/ml) rate was 86.6%. Comorbidity and EDSS scores of patients with low BMD were significantly higher than those of the remaining patients (P = 0.000 and P = 0.015, respectively). Neck BMD was inversely correlated with comorbidity score, disease duration, relapse number, and lifetime steroid intake (r = - 0.270, r = - 0.263, r = - 0.359, and r = - 0.314, respectively).

CONCLUSION

The current study revealed that low BMD and vitamin D insufficiency were common in patients with MS. Longer disease duration, higher comorbidity score, and severe disability level led to lower BMD values. In conclusion, it is of paramount importance for clinicians to pay more attention on bone health in MS and to tailor preventative measures meticulously.

摘要

目的

确定多发性硬化症(MS)患者低骨矿物质密度(BMD)的患病率及危险因素。

方法

纳入2010年1月至2013年12月期间接受双能X线吸收法(DXA)进行BMD评估的MS患者。从病历数据库和电话访谈中获取描述性数据、BMD值、骨质疏松症的危险因素以及MS的详细信息,如发病年龄、病程、MS临床类型、扩展残疾状态量表(EDSS)评分和终生类固醇摄入量。

结果

研究组包括67例患者,平均年龄为41.1±10.2岁。其中,按实际年龄计算,20.9%的患者显示BMD较低。维生素D不足(25(OH)D<20 ng/ml)率为86.6%。BMD较低患者的合并症和EDSS评分显著高于其余患者(分别为P = 0.000和P = 0.015)。颈部BMD与合并症评分、病程、复发次数和终生类固醇摄入量呈负相关(分别为r = -0.270、r = -0.263、r = -0.359和r = -0.314)。

结论

当前研究表明,MS患者中低BMD和维生素D不足很常见。病程较长、合并症评分较高和残疾程度较重会导致较低的BMD值。总之,临床医生对MS患者的骨骼健康给予更多关注并精心制定预防措施至关重要。

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