title: Bone mineral density in patients with multiple sclerosis, hereditary ataxia or hereditary spastic paraplegia after at least 10 years of disease - a case control study.
abstract: BACKGROUND
  Although disability is considered the main cause of low bone mineral density (BMD) in multiple sclerosis (MS), other factors related to the disease process or treatment could also be involved. The aim of this study was to assess whether patients with MS are more likely to develop low BMD (osteopenia or osteoporosis) than patients with the non-inflammatory neurological diseases Hereditary Spastic Paraplegia (HSP) and Hereditary Ataxia (HA).
  
  
  METHODS
  We performed a case control study comparing BMD (spine, hip and total body) and biochemical measures of bone metabolism in 91 MS patients and 77 patients with HSP or HA, matched for age, gender and disability. Both patient groups had lived with the disease for at least 10 years.
  
  
  RESULTS
  In total 74.7% of the patients with MS and 75.3% of the patients with HSP or HA had osteopenia (-2.5 < T- score < -1.0) or osteoporosis (T- score ≤ -2.5) in one or more sites. Osteoporosis was more common in patients with MS than with HSP/HA (44.0 vs 20.8%, p =0.001). This difference was not significant after correction for confounders (p = 0.07), nor were any of the biochemical markers.
  
  
  CONCLUSIONS
  Most patients with disabling neurological diseases like MS and HSP/HA develop osteopenia or osteoporosis. MS patients had osteoporosis more frequently than HA/HSP patients, though the difference was not significant after adjusting for confounders. Osteoporosis and bone health should be considered in all patients with both inflammatory and degenerative chronic neurological diseases.
authors.affiliation: Department of Neurology, Drammen Hospital, Vestre Viken HF, Dronnigsgate 28, 3004, Drammen, Norway. c.s.simonsen@studmed.uio.no.|Department of Neurology, Oslo University Hospital, Oslo, Norway. c.s.simonsen@studmed.uio.no.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. c.s.simonsen@studmed.uio.no.
authors.forename: Cecilia Smith
authors.initials: CS
authors.lastname: Simonsen
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.|Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Elisabeth Gulowsen
authors.initials: EG
authors.lastname: Celius
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Brunborg
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Chantal
authors.initials: C
authors.lastname: Tallaksen
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Erik Fink
authors.initials: EF
authors.lastname: Eriksen
authors.affiliation: Department of Neurology, Akershus University Hospitals, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Trygve
authors.initials: T
authors.lastname: Holmøy
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.
authors.forename: Stine Marit
authors.initials: SM
authors.lastname: Moen
mesh_terms: D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism; D015419:Spastic Paraplegia, Hereditary / Q000150:complications*; D013132:Spinocerebellar Degenerations / Q000150:complications*
keywords: Bone Mineral Density; Case control; Hereditary Ataxia; Hereditary Spastic Paraparesis; Multiple Sclerosis; Osteoporosis