Bone health in patients with multiple sclerosis. Analysis of bone mineral density and 3D-reconstruction of proximal femur by DXA

Londres

Congreso; World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases WCO-IOF-ESCEO; 2021

WCO-IOF-ESCEO

Evaluation of bone health in patients with Multiple Sclerosis. Analysis of bone mineral density and 3D-reconstruction of proximal femur by DXA 1María Rosa Ulla, 2Carlos Vrech, 3Lucas Brun, 3Lorena Brance, 4Elena Peralta López, 1María José Castro, 1Florencia Martos, 4María Angélica Rivoira. 1 Fundación ILAIM, Córdoba, Argentina; 2 Sanatorio Allende, Córdoba, Argentina, 3 CONICET - Facultad de Ciencias Médicas, UNR, Rosario, Argentina, 4Facultad de Ciencias Médicas, UNC, Córdoba, Argentina.Relapsing-remitting multiple sclerosis (RRMS) is an autoimmune demyelinating disease affecting 32 per 100000 Argentinians. Given the high rate of falls and fractures and the bone-damaging treatment with corticosteroids, the aim of our study was to compare phosphocalcic metabolism and bone mineral density of RRMS-patients with that of healthy controls. Materials and methods: Observational, prospective and open study in 40 RRMS-patients aged 16-59 years and 40 matched controls (C). Serum levels of calcium, ionic calcium, phosphorus, magnesium, alkaline phosphatase, PTH, osteocalcin, β-crosslaps and 25-(OH)-vitamin D were evaluated. BMD (g/cm2) was measured by DXA on lumbar spine (LS), femoral neck (FN) and total hip (TH). 3D analysis was performed with 3D-Shaper software. A survey of physical activity, sun exposure and dairy consumption was carried out. Shapiro-Wilk test and parametric or non-parametric tests were used. Data were expressed as mean±SD and p<0.05 was considered significant. Results: No differences in BMD (g/cm2) was observed between RRMS and C in all areas analyzed (LS: C 0.998±0.141 vs RRMS 0.986±0.119, p>0.05; FN: C 0.817±0.123 vs RRMS 0.794±0.140, p>0.05; TH: C 0.926±0.127 vs RRMS 0.908±0.131, p>0.05). Accordingly, the Z-score was also similar. In addition, the 3D analysis of the hip showed no differences: sDens (mg/cm2): C 161.8±22.2 vs RRMS 161.0±24.3 p>0.05; trab vBMD (mg/cm3): C 206.7±42.3 vs RRMS 203.5±44.5 p>0.05). Patients with RRMS had lower serum levels of 25-(OH)-vitamin D and alkaline phosphatase (21.1 ± 7.8 vs 38.3 ± 14.8 ng/ml and 84.6 ± 36.9 vs 136.3 ± 51.7 U/L, p <0.001, respectively). RRMS-patients performed more physical activity (1.50 ± 0.04 vs 0.81 ± 0.05, hours/day, p <0.05). Dairy consumption was low in both groups (500 mgCa/day) and 70% of RRMS-patients had inadequate sun exposure. Conclusions: Lower vitamin D and alkaline phosphatase did not translate into lower BMD, partially due to greater physical activity in RRMS-patients.