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Bone Mineral Density Loss in Relapsing-remitting Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A
Elham Sadat Azimi1, Aysa Shaygannejad1, Saeed Vaheb1
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
International Journal of Preventive Medicine
|June 26, 2026
Summary
Neuromyelitis Optica Spectrum Disorder (NMOSD) patients face a threefold increased risk of bone density loss compared to healthy individuals. Relapsing Remitting Multiple Sclerosis (RRMS) patients showed no significant difference in bone density loss risk.
Area of Science:
- Neurology
- Bone Metabolism
- Immunology
Background:
- Previous research indicates a link between bone mineral density (BMD) and Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD).
- The specific risk of BMD loss and its contributing factors in Relapsing Remitting MS (RRMS) and NMOSD patients require further investigation.
Purpose of the Study:
- To evaluate the prevalence of osteopenia and osteoporosis in RRMS and NMOSD patients.
- To identify factors associated with BMD loss in these patient populations.
Main Methods:
- A matched case-control study was conducted in Iran from November 2022 to November 2023.
- Bone densitometry was performed on the femoral neck and lumbar spine in RRMS patients, NMOSD patients, and healthy controls (HCs).
- Logistic and linear regression analyses were used to identify associated risk factors for osteopenia and osteoporosis.
Main Results:
- NMOSD patients exhibited a significantly higher probability of osteopenia or osteoporosis compared to HCs (OR = 3.3, P = 0.02).
- RRMS patients did not show a significant difference in the odds of osteopenia or osteoporosis compared to HCs (OR = 1.7, P = 0.34).
- Factors associated with BMD loss in NMOSD included age, EDSS, physical activity, alkaline phosphatase (ALP), vitamin D3, and phosphorus levels. In RRMS, only ALP levels were significantly associated with BMD loss.
Conclusions:
- NMOSD is associated with a threefold increased risk of bone density loss compared to healthy individuals.
- No significant association was found between RRMS and bone density loss.
- Routine evaluation and preventive measures for BMD loss are recommended for NMOSD patients.
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