Comparison of the Bone Turn-over Markers in Patients with Multiple Sclerosis and Healthy Control Subjects

One of the major concerns for patients with multiple sclerosis (MS) is developing osteoporosis, especially when corticosteroid treatment is used. The aim of the present study is to compare the bone turnover markers in patients with multiple sclerosis and healthy control subjects. A total of 176 subjects were enrolled in this case-control. Ninety-one MS patients with mean age of 35.26 ± 8.76 yrs were randomly selected from the Committee on Multiple Sclerosis Registry. The control group was composed of 85 healthy subjects who were recruited from the Iranian Multicenter Osteoporosis Study (IMOS). Fasting serum levels of parathyroid hormone (PTH), 25 (OH) D3, osteocalcin and cross laps were measured in two groups. Hip and spine BMD were measured using DXA. Our findings showed significant differences in hip BMD and its T-score and Z-score values between MS patients and the control group. Osteoporosis prevalence at hip area of the MS patients was almost 5 times higher than the control group [OR=4.66, (95% CI 0.97 to 22.27), RR=4.29, (95% CI 0.95 to l9.32), p value=0.03]. No significant difference was found in BMD L2-L4, BMD T-score and BMD Z-score of lumbar area between two groups. The PTH and cross laps serum concentrations in MS patients were significantly higher than the control group. We did not find significant difference in serum osteocalcin level between the two groups. We concluded that in our study the serum levels of bone resorbtion markers in MS patients were significantly higher than the healthy control group. This may explain, at least in part, the elevated susceptibility of MS patients for developing osteoporosis.