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Updated: May 31, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Low bone mass in newly diagnosed multiple sclerosis and clinically isolated syndrome
S M Moen1, E G Celius, L Sandvik
1Department of Neurology, Oslo University Hospital Ulleval, 0407 Oslo, Norway. s.m.moen@medisin.uio.no
Objective:
Osteoporosis is common in patients with multiple sclerosis (MS) with long-standing disease. Hypovitaminosis D is a candidate risk factor for MS, and vitamin D also mediates bone mineralization. If vitamin D exerts a major effect on MS risk, skeletal consequences of hypovitaminosis D could be apparent shortly after the onset of MS. In order to test this hypothesis, we assessed bone mineral density (BMD) at early stages of disease in patients with no or minor disability.
Methods:
A population-based case-control study was conducted on 99 consecutive and newly diagnosed patients with clinically isolated syndrome or MS, and on 159 age-, sex-, and ethnicity-matched controls. BMD was measured by dual-energy x-ray absorptiometry of the femoral neck, total hip, anterior-posterior lumbar spine, total body, and nondominant ultradistal radius.
Results:
A total of 50.5% of the patients exhibited either osteopenia (-2.5 < T score < -1.0) or osteoporosis (T score ≤-2.5) in at least one skeletal site, compared to 37.1% of controls (p = 0.034). After adjusting for possible confounders, left femoral total hip T score and lumbar spine BMD and T score were significantly lower in patients than in controls (p = 0.023, 0.039, and 0.026, respectively).
Conclusions:
Low bone mass appears to occur early in MS. This is compatible with shared etiologic or pathogenic factors in MS and osteoporosis, and calls for an active approach to optimize bone health in early stages of MS.
Insights
Low bone mass, including osteopenia and osteoporosis, is prevalent in early stages of multiple sclerosis (MS). This suggests shared risk factors between MS and bone density loss, necessitating early bone health interventions for MS patients.
Area of Science:
- Neurology
- Endocrinology
- Bone Metabolism
Background:
- Osteoporosis is common in long-standing multiple sclerosis (MS).
- Hypovitaminosis D is a potential risk factor for MS and is crucial for bone mineralization.
- Skeletal consequences of low vitamin D may appear early in MS.
Purpose of the Study:
- To assess bone mineral density (BMD) in early stages of MS.
- To investigate the relationship between MS onset and skeletal health.
- To determine if low bone mass is present in patients with minimal disability.
Main Methods:
- Population-based case-control study.
- 99 newly diagnosed patients with clinically isolated syndrome or MS.
- 159 age-, sex-, and ethnicity-matched controls.
- BMD measured using dual-energy x-ray absorptiometry at multiple skeletal sites.
Main Results:
- 50.5% of MS patients had osteopenia or osteoporosis versus 37.1% of controls (p=0.034).
- Significantly lower total hip and lumbar spine BMD and T-scores in MS patients compared to controls after adjustment.
- Adjusted p-values for hip T-score, lumbar spine BMD, and lumbar spine T-score were 0.023, 0.039, and 0.026, respectively.
Conclusions:
- Low bone mass is an early finding in multiple sclerosis (MS).
- Shared etiologic or pathogenic factors may link MS and osteoporosis.
- Proactive bone health management is recommended for early-stage MS patients.
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