Multiple sclerosis, a cause of secondary osteoporosis? What is the evidence and what are the clinical implications?
Acta Neurol Scand Suppl. 2011;(191):44-9. doi: 10.1111/j.1600-0404.2011.01543.x.
Kampman MT, Eriksen EF, Holmøy T.
Centre for Clinical Research and Education, University Hospital of North Norway, Tromsø, Norway Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Clinical Endocrinology, Oslo University Hospital, Aker, Oslo, Norway Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Background?- Both women and men with multiple sclerosis (MS) are at increased risk of developing osteoporosis. Methods?- A non-systematic review of the prevalence, pathogensis and treatment of osteoporosis in patients with multiple sclerosis.
Results?- MS and osteoporosis share aetiological risk factors such as smoking and hypovitaminosis D, as well as pathegenetic 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.
Conclusion?- 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.
© 2011 John Wiley & Sons A/S.
– – – – – – – – – – – – – –
See also VitaminDWiki
- All items in MS and vitamin D 101 items as of July 2011
- Overview of MS and Vitamin D
- Reduced vitamin D and BMD and Neurological Conditions – April 2011
- Notes bone problems with medical problems which are associated with low vitamin D
- spinal cord injury, stroke, multiple sclerosis, Parkinson’s disease, and traumatic brain injury
- Google Search of VitaminDWiki: ("MS OR" Multiple Sclerosis") +osteoporosis 130 items July 2011
- 2800 IU vitamin D daily did not decrease bone loss for those with MS – March 2011
- Note nearly enough: probably need 5,000 - 10,000 IU
- Increased Bone Risk in MS Patients Even Early in Disease Course July 2011 - MedScape
- July issue of Neurology, 50% of the MS patients had osteopenia
Following chart shows the vicious cycle for MS: Low vitamin D==> MS ==> lower vitamin D