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NEUROLOGY 2009;73:1394-1398
© 2009 American Academy of Neurology

A cross-sectional study of bone health in multiple sclerosis

Ruth Ann Marrie, MD, PhD, Gary Cutter, PhD, Tuula Tyry, PhD and Timothy Vollmer, MD

From the Department of Medicine (R.A.M.), University of Manitoba, Winnipeg, Canada; Department of Biostatistics (G.C.), University of Alabama at Birmingham; Division of Neurology (T.T.), Barrow Neurological Institute, Phoenix, AZ; and Department of Neurology (T.V.), University of Colorado, Denver.

Address correspondence and reprint requests to Dr. Ruth Ann Marrie, Health Sciences Center, GF-533, 820 Sherbrook Street, Winnipeg, MB, Canada R3A 1R9 rmarrie{at}hsc.mb.ca

Background: Osteoporosis is an important risk factor for fragility fractures. Although osteoporosis is considered common in multiple sclerosis (MS), few previous studies focused on fractures in MS.

Objective: Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we investigated the frequency of osteoporosis, fractures, and clinical risk factors for fracture in MS.

Methods: In 2007, 9,346 NARCOMS participants reported fractures and clinical risk factors for fractures including history of osteoporosis or osteopenia (low bone mass), sedentary level of physical activity, falls in the last year, current smoking status, family history of osteoporosis, and impaired mobility.

Results: Among responders, 2,501 (27.2%) reported low bone mass. More than 15% of responders reported a history of fracture after age 13 years (n = 1,482). Among those reporting fractures, 685 (46.2%) reported multiple fractures, while 522 (35.2%) reported a wrist fracture, 165 (11.1%) reported a vertebral fracture, and 100 (7.4%) reported a hip fracture. Excluding age, 1,413 (15.1%) participants had 1 clinical risk factor for fracture, 2,341 (25.0%) had 2, and 5,393 (57.7%) had 3 or more. Among participants with a history of fracture, 746 (55%) reported taking calcium supplements, 858 (68.8%) reported taking vitamin D supplements or a multivitamin with vitamin D, and 334 (22.5%) reported taking a bisphosphonate.

Conclusion: Patients with multiple sclerosis (MS) often have multiple risk factors for osteoporotic fractures. Many patients with MS with low bone mass or previous fractures are not taking supplemental calcium or vitamin D, suggesting a potential area of improvement in care.

Abbreviations: MS = multiple sclerosis; NARCOMS = North American Research Committee on Multiple Sclerosis; PDDS = Patient Determined Disease Steps; SES = socioeconomic status.

Disclosure: Author disclosures are provided at the end of the article.

Received April 12, 2009. Accepted in final form August 7, 2009.




Correspondence:

Read all Correspondence

A cross-sectional study of bone health in multiple sclerosis
Hongliang Zhang, et al.
Neurology Online, 24 Jan 2010 [Full text]
Reply from the authors
Ruth Ann Marrie, et al.
Neurology Online, 24 Jan 2010 [Full text]