title: Bone turnover and metabolism in patients with early multiple sclerosis and prevalent bone mass deficit: a population-based case-control study.
abstract: BACKGROUND
  Low bone mass is prevalent in ambulatory multiple sclerosis (MS) patients even shortly after clinical onset. The mechanism is not known, but could involve shared etiological risk factors between MS and low bone mass such as hypovitaminosis D operating before disease onset, or increased bone loss after disease onset. The aim of this study was to explore the mechanism of the low bone mass in early-stage MS patients.
  
  
  RESULTS
  We performed a population-based case-control study comparing bone turnover (cross-linked N-terminal telopeptide of type 1 collagen; NTX, bone alkaline phosphatase; bALP), metabolism (25-hydroxy- and 1, 25-dihydroxyvitamin D, calcium, phosphate, and parathyroid hormone), and relevant lifestyle factors in 99 patients newly diagnosed with clinically isolated syndrome (CIS) or MS, and in 159 age, sex, and ethnicity matched controls. After adjustment for possible confounders, there were no significant differences in NTX (mean 3.3; 95% CI -6.9, 13.5; p = 0.519), bALP (mean 1.6; 95% CI -0.2, 3.5; p = 0.081), or in any of the parameters related to bone metabolism in patients compared to controls. The markers of bone turnover and metabolism were not significantly correlated with bone mass density, or associated with the presence of osteoporosis or osteopenia within or between the patient and control groups. Intake of vitamin D and calcium, reported UV exposure, and physical activity did not differ significantly.
  
  
  CONCLUSIONS
  Bone turnover and metabolism did not differ significantly in CIS and MS patients with prevalent low bone mass compared to controls. These findings indicate that the bone deficit in patients newly diagnosed with MS and CIS is not caused by recent acceleration of bone loss, and are compatible with shared etiological factors between MS and low bone mass.
authors.affiliation: Department of Neurology, Oslo University Hospital Ullevål, Oslo, Norway. s.m.moen@medisin.uio.no
authors.forename: Stine Marit
authors.initials: SM
authors.lastname: Moen
authors.forename: Elisabeth Gulowsen
authors.initials: EG
authors.lastname: Celius
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Magritt
authors.initials: M
authors.lastname: Brustad
authors.forename: Lars
authors.initials: L
authors.lastname: Nordsletten
authors.forename: Erik Fink
authors.initials: EF
authors.lastname: Eriksen
authors.forename: Trygve
authors.initials: T
authors.lastname: Holmøy
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D016022:Case-Control Studies; D006801:Humans; D009103:Multiple Sclerosis / Q000378:metabolism*; D010024:Osteoporosis / Q000378:metabolism*
chemical_list: D015415:Biomarkers