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Published on: January 29, 2018
BMI levels with MS Bone mineral density levels in adults with multiple sclerosis: a meta-analysis
Zhongming Huang1, Yiying Qi1, Shaohua Du1
1a Department of Orthopedic Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China.
Introduction:
Multiple sclerosis (MS) and osteoporosis (OP) affect a substantial proportion of the population. Accumulating evidence suggests that MS patients are at high risk for OP. We performed a meta-analysis to identify risk factors for lowered bone mineral density (BMD) in MS patients.
Methods:
We searched for articles within the Medline, Embase and Cochrane Library databases, published up to March 2014, pertaining to associations between MS and BMD. A total of 11 studies was included in the meta-analysis.
Results:
The analysis indicated that MS patients have reduced lumbar spine, femur neck, and hip BMD compared with healthy controls (lumbar spine, standardized mean difference (SMD) = -0.76, 95% CI: -1.07, -0.45; femur neck, SMD = -0.56, 95% CI: -0.84, -0.29; and hip, SMD = -0.62, 95% CI: -0.96, -0.29). Further subgroup analysis revealed that a disease duration of >7 years, total steroid dose during the disease of >15 g, and an Expanded Disability Status Scale (EDSS) score of > 3, increased the risk of reduced BMD in the lumbar spine and femoral neck, but not in the hip. Meta-regression analysis did not explain the heterogeneity in the clinical characteristics or outcome definitions.
Conclusions:
Our meta-analysis suggests that MS patients have reduced overall BMD compared with healthy controls. Furthermore, disease duration (>7 years), total steroid dose (>15 g), and EDSS score (>3) are risk factors for reduced BMD in MS patients.
Insights
Multiple sclerosis patients often have lower bone mineral density (BMD). Risk factors for reduced BMD in MS include longer disease duration, higher steroid doses, and greater disability, impacting spine and hip health.
Area of Science:
- Neuroscience
- Endocrinology
- Rheumatology
Background:
- Multiple sclerosis (MS) and osteoporosis (OP) are prevalent conditions.
- MS patients exhibit an elevated risk for developing OP.
- Understanding risk factors for lowered bone mineral density (BMD) in MS is crucial.
Purpose of the Study:
- To conduct a meta-analysis identifying risk factors for reduced BMD in MS patients.
- To quantify the association between MS and lowered BMD across different skeletal sites.
Main Methods:
- Systematic literature search of Medline, Embase, and Cochrane Library databases up to March 2014.
- Inclusion of 11 studies in the meta-analysis.
- Subgroup and meta-regression analyses to explore risk factors and heterogeneity.
Main Results:
- MS patients demonstrated significantly reduced BMD at the lumbar spine, femur neck, and hip compared to controls.
- Factors associated with decreased BMD included disease duration exceeding 7 years, cumulative steroid dose over 15g, and Expanded Disability Status Scale (EDSS) score above 3.
- These risk factors specifically impacted lumbar spine and femur neck BMD, but not hip BMD.
Conclusions:
- MS patients generally present with lower overall BMD.
- Disease duration, cumulative steroid exposure, and neurological disability (EDSS) are significant risk factors for reduced BMD in this population.
- Targeted interventions addressing these factors may help mitigate bone loss in MS patients.
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