title: Bone metabolism and vitamin D status in patients with multiple sclerosis.
abstract: BACKGROUND
  Vitamin D (VD), an important factor for bone health immobilization and immune regulation, has been shown to have low serum concentration in multiple sclerosis (MS) patients. Those patients have also multiple fracture risk factors, including progressive immobilization and long-term glucocorticoids treatment. The aim of the study was to analyze bone health (osteopenia or osteoporosis prevalence) and VD serum concentration in MS patients as well as the influence of disease activity and treatment on bone health.
  
  
  METHODS
  The study involved 72 MS patients: 52 women and 20 men. Mean age was 40.3±10.5 yrs, mean EDSS (Expanded Disability Status Scale) 3.3±1.9. Bone health was analyzed using standard densitometry in the lumbar spine and femoral neck. Serum levels of VD, calcium, phosphate and parathormone were assessed. We compared two groups of patients with multiple sclerosis: relapsing - remitting MS (RRMS) and progressive relapsing MS (PRMS).
  
  
  RESULTS
  Densitometry revealed osteopenia in twenty-six (36.1%) patients and osteoporosis in eleven (15.3%), no bone fractures were presented. Sixty-eight MS patients (94.4%) had lower VD serum level if compared to population referential values. Thirteen patients (18.1%) had severe VD deficiency. Densitometry parameter (T-score of the lumbar spine) worsened with EDSS increase (r=-0.43, P=0.001). There was a statistically significant negative correlation between VD concentration and EDSS score (r=-0.31; P=0.009).
  
  
  CONCLUSIONS
  Our study indicates that patients with MS have high incidence of osteopenia and osteoporosis and vitamin D deficiency. Bone health disturbances studied by densitometry are related to the disability caused by MS.
authors.affiliation: Department of Neurology, Medical University of Warsaw, Warsaw, Poland. Electronic address: kkepczy@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kępczyńska
authors.affiliation: Department of Neurology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Zajda
authors.affiliation: Department of Epidemiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Lewandowski
authors.affiliation: Chair and Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Przedlacki
authors.affiliation: Department of Neurology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Zakrzewska-Pniewska
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000150:complications / Q000378:metabolism*; D002118:Calcium / Q000097:blood; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000097:blood / Q000150:complications / Q000378:metabolism*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood / Q000150:complications / Q000378:metabolism*; D010024:Osteoporosis / Q000097:blood / Q000150:complications / Q000378:metabolism*; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000378:metabolism*
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium
keywords: Bone health; Multiple sclerosis; Osteopenia; Osteoporosis; Vitamin D deficiency