PT  - JOURNAL ARTICLE
AU  - Nieves, J.
AU  - Cosman, F.
AU  - Herbert, J.
AU  - Shen, V.
AU  - Lindsay, R.
TI  - High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis
AID  - 10.1212/WNL.44.9.1687
DP  - 1994 Sep 01
TA  - Neurology
PG  - 1687--1687
VI  - 44
IP  - 9
4099  - http://n.neurology.org/content/44/9/1687.short
4100  - http://n.neurology.org/content/44/9/1687.full
SO  - Neurology1994 Sep 01; 44
AB  - Background: Female patients with multiple sclerosis (MS) are at risk for osteoporosis because of gender, immobility, and corticosteroid use. Methods: Bone mineral density (BMD) was measured by dual x-ray absorptiometry in 80 female MS patients admitted to a tertiary care hospital. All patients completed a questionnaire that included measurements of dietary intake and sunlight exposure. Biochemical indices of bone metabolism and turnover were measured in a random sample of 52 patients. Results: BMD of the lumbar spine and femoral neck was 1 to 2 SDs lower in MS women compared with a healthy reference population. BMD was lower in patients with more severe MS. The mean 25(OH)D level of the sample population (43 nmol/1) was in the insufficient range, and 12 patients (23%) had frank vitamin D deficiency (< 25 nmol/1). BMD and age-related BMD (z scores) at all skeletal sites measured were lowest when 25(OH)D levels were deficient. Parathyroid hormone (PTH) was frankly elevated in 13% of patients. PTH levels were negatively correlated with 25(OH)D levels and with BMD. Dietary intake of vitamin D was below the recommended level in 80% of patients, and 40% reported no weekly sunlight exposure. After controlling for age, cumulative steroid use was not a determinant of BMD. Conclusions: BMD was significantly reduced in female MS patients, which might increase fracture risk two- to threefold. Vitamin D deficiency with secondary hyperparathyroidism is prevalent and is probably a significant cause of low BMD in this population. Vitamin D deficiency in the female MS patient might be safely and inexpensively corrected by the routine use of vitamin D supplements.