Markers of bone remodeling predict rate of bone loss in multiple sclerosis patients treated with low dose glucocorticoids.
BACKGROUND
The aim of this study was to evaluate the clinical value of markers of bone remodeling in assessment of rate of bone loss in patients with multiple sclerosis (MS) long term treated with low dose glucocorticoids.


METHODS
The study involved 70 patients with MS. Motor function of the patients was evaluated using the Kurtzke Expanded Disability Status Scale (KEDSS). Bone mineral density (BMD) was determined at the lumbar spine and proximal femur at baseline and after 1.8 +/- 0.8 years. Bone remodeling was assessed using circulating concentrations of type 1 collagen cross-linked C-telopeptide (beta CTX), aminoterminal propeptide of type I procollagen, and N-MID osteocalcin (OC). A control group of 140 age-matched healthy subjects was used to compare bone-turnover markers.


RESULTS
The plasma CTX concentration was the most significant parameter of bone remodeling which correlated with the rate of bone loss and with the KEDSS. The rate of bone loss at the proximal femur was not significantly different between tertiles of plasma OC concentrations.


CONCLUSIONS
In physically active patients with MS treated with low-dose GC, the bone-turnover markers were not different from controls. Patients having plasma CTX but markers of bone formation higher as compared to controls were confirmed 2 years later as bone losers.
Stepan
Jan J
JJ
Department of Internal Medicine 3, Charles University Faculty of Medicine, U Nemocnice 1, CZ-128 00, Prague, Czech Republic. jstepan@vol.cz
Havrdová
Eva
E
Týblová
Michaela
M
Horáková
Dana
D
Tichá
Veronika
V
Nováková
Iveta
I
Zikán
Vít
V
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016723:Bone Remodeling; D001862:Bone Resorption / Q000139:chemically induced / Q000175:diagnosis*; D004305:Dose-Response Relationship, Drug; D015444:Exercise; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D017698:Postmenopause; D011379:Prognosis
D015415:Biomarkers; D005938:Glucocorticoids