Alʹmanah Kliničeskoj Mediciny (Feb 2016)

PREVALENCE AND PREDICTORS OF LOW BONE MINERAL DENSITY IN PATIENTS WITH MULTIPLE SCLEROSIS IN YOUNG AGE

  • E. L. Turova,
  • E. V. Kozhemyakina,
  • P. S. Pukhtinskaya,
  • O. M. Lesnyak

DOI
https://doi.org/10.18786/2072-0505-2014-32-61-65
Journal volume & issue
Vol. 0, no. 32
pp. 61 – 65

Abstract

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Background: Multiple sclerosis is a chronic autoimmune progressing disease of the nervous system characterized by increased fracture risk due to a series of causes including the low bone mineral density (BMD). According to the literature data, the multiple sclerosis patients of a young age can already have BMD under the age norm. Factors associated with low BMD in such patients need to be investigated. Aim: Assessment of the prevalence of the low BMD level in young multiple sclerosis patients and revealing factors enabling its decrease. Materials and methods: Age was a patient criterium for including into the study: 18 to 50 years for men and 18 to menopause – for women. Under examination there were 163 patients with multiple sclerosis, 111 women (68.1%) and 52 men (31.9%) with mean age of 36.1±7.6 years. Relapsing-remitting multiple sclerosis was diagnosed in 121 (74.2%) patients, secondary progressive multiple sclerosis – in 37 (22.7%), and primary progressive multiple sclerosis – in 5 (3.1%). Score median according to the Expanded Disability Status Scale (EDSS) was 3.5 (25% and 75% quartiles – [2,0; 5,5]). The median of the disease duration was 8.5 [5.0; 14.0] years. BMD measuring was carried out using dual-energetic roentgen absorptiometry. Investigation was performed on two skeleton points: on the lumbar spine and proximal hip. Results: Decrease of BMD to under the age norm according to Z-criterion was revealed in 30 (18.4%) patients. The results obtained has shown that the body mass index (odds ratio (OR) 0.8; 95% confidence interval (CI) 0.7-0.9, p=0.001), disease duration (OR 1,1; 95% CI 1.0-1.2, p=0.023), the number of gluco-corticosteroid therapy courses (ОR 1.3; 95% CI 1.0-1.6, р=0.03), and smoking (ОR 2.7; 95% CI 1.0-7.2, р=0.04) are independent factors causing low BMD values in the patient population of multiple sclerosis studied. Conclusion. Every forth multiple sclerosis patient has decreased BMD in young age. Disease duration, low body mass index, gluco-corticosteroid taking, and smoking are significant factors influencing BMD in the young population of multiple sclerosis studied.

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