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

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An Erratum to this article was published on 13 February 2010

Abstract

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 ≤−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.

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Acknowledgments

We thank the patients for participating in the study. At the University Hospital of North Norway, study nurses Grethe Berg Johnsen and Marianne Røst (Department of Neurology) and May Rokstad Solem and Elin Hanssen (Clinical Research Department) performed measurements and function tests. Elin Møller punched questionnaire data and Inger Sperstad handled files (Clinical Research Centre). Ole Martin Sand performed 25(OH)D measurements (Department of Clinical Chemistry). At the University of Tromsø, Institute of Community Medicine, Guri Skeie performed nutrition calculations and Bjørn Straume provided statistical advice. The study received financial support from the University of Tromsø, the Research Council of Norway, and Odd Fellows Research Foundation for Multiple Sclerosis.

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Authors and Affiliations

  1. Department of Neurology, University Hospital of North Norway, P.O. Box 33, 9038, Tromsø, Norway

    Linn Hofsøy Steffensen, Svein Ivar Mellgren & Margitta T. Kampman

  2. Department of Clinical Medicine, University of Tromsø, Tromsø, Norway

    Linn Hofsøy Steffensen, Svein Ivar Mellgren & Margitta T. Kampman

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  1. Linn Hofsøy Steffensen
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  2. Svein Ivar Mellgren
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  3. Margitta T. Kampman
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Correspondence to Linn Hofsøy Steffensen.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00415-010-5470-2

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Steffensen, L.H., Mellgren, S.I. & Kampman, M.T. Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis. J Neurol 257, 410–418 (2010). https://doi.org/10.1007/s00415-009-5337-6

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