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Abstract
Objective To compare measures of bone mineral density (BMD) between people with and without MS.
Methods Using population-based administrative data from Manitoba, Canada, we identified people with MS who received BMD screening and controls who received BMD screening matched 5:1 on age, sex, region of residence, and date of BMD screening. We determined the BMD T-scores for the femoral neck, total hip, and lumbar spine and frequency of osteoporosis (defined as T-score −2.5 or lower). We compared the groups with respect to the femoral neck T-score using multivariable linear regression, adjusting for age, sex, region, disability, continuity of care, recent previous fracture, falls history, medication use, and comorbidities. We compared the odds of osteoporosis between groups using multivariable logistic regression analysis.
Results We identified 783 MS cases who underwent BMD screening and 3,915 matched controls. The mean (SD) femoral BMD T-score was lower in MS cases (−1.48 [1.08]) than in matched controls (−1.12 [0.98], p < 0.001), and the prevalence of osteoporosis was higher among the MS cases (range across BMD sites: 16%–26%) vs controls (6%–15%). MS was associated with a lower femoral neck BMD T-score after accounting for covariates (β = −0.24; 95% CI: −0.32 to −0.17) and more than 2-fold increased odds of osteoporosis (covariate-adjusted OR 2.41; 95% CI: 1.82–3.19).
Conclusions People with MS have lower BMD and a higher prevalence of osteoporosis compared with people of similar age and sex without MS. These findings indicate the importance of addressing bone health as part of comprehensive MS care.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received November 18, 2018.
- Accepted February 15, 2019.
- © 2019 American Academy of Neurology
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