The relationship between bone mineral density and high-dose short-term corticosteroid therapy in patients with Multiple sclerosis

Abstract

Introduction: Previous studies were reported that osteoporosis and bone fracture occurs more frequently among Multiple sclerosis patients than the general population. The aim of this study to investigate the effects of total doses of short-term, high dose corticosteroids on bone mineral density and other affecting factors for bone mineral density in Relapsing-remitting type Multiple Sclerosis patients. Material and methods: Fifty-four patients (37 females, 17 males) with relapsing-remitting type Multiple Sclerosis who filled the diagnostic criteria according to McDonald criteria were included in the study. Femoral and lumbar bone mineral density were measured using dual energy X-ray absorptiometry. Expanded Disability Status Scale, disease duration, number of attacks, cumulative corticosteroid dose were recorded. Serum calcium, potassium, phosphorus, vitamin D, parathormone and osteocalcin levels were measured. Patients were divided into two groups: patients who have received at least 20 g intravenous metilprednisolone (Group I) and patients who have received less than 20 g intravenous metilprednisolone (Group II). We analysed association between cumulative corticosteroid dose and each parameters. Results: Osteopenia was present in 46.2% and osteoporosis in 5.5% of the study population according to femoral neck bone mineral density. Femoral bone mineral density was significantly lower among patients. There was no correlation between cumulative dose of corticosteroid and bone mineral density. Conclusion: Low bone mineral density and osteoporosis are common in Multiple sclerosis patients. High-dose steroid therapy is not be the primary cause of osteoporosis in patients with multiple sclerosis.