Contributions
Abstract: P319
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: MS patients are at increased risk of reduced bone mineral density (BMD) and fractures. To date, the etiology of bone loss in MS is unclear. As we previously reported (Olsson et al. MS Journal 2015), age, body mass index (BMI) and disease severity were the principal factors associated with reduced BMD in our cohort. Trabecular bone score (TBS) is a recently developed analytical tool that provides a measurement of the three-dimensional bone microarchitecture. Decreased TBS predicts an increased fracture risk independently of BMD. To date, no studies have investigated the TBS in MS patients.
Objectives: To assess bone quality in MS patients by TBS and to evaluate potential risk factors that may affect BMD and TBS in patients with MS.
Methods: 260 patients from the Danish MS Center were included in the study. Data on BMD - measured by dual x-ray absorptiometry (DXA) in the period 2012 to 2013 - were previously published. The antero-posterior spine images from these scans were reanalysed and TBS was calculated using the TBS iNsight software (MediMaps®, Merignac, France). Students t-test and univariate regression analyses were performed with additional information on smoking, alcohol, sun exposure, physical activity, diet, BMI at year 20, and vitamin D supplements - all parameters were obtained from questionnaires. Disease severity was assessed by the Expanded Disability Status Scale (EDSS).
Results: The TBS values were not significantly different from those of an age-matched reference population. Low TBS was associated with high age (p< 0.0001) and high EDSS (p=0.021). Low BMI at 20 years of age was associated with low BMD in both lumbar spine (p=0.016) and femur (p< 0.005). Neither the number of smoking pack-years nor alcohol consumption was associated with BMD. When dichotomized into never smokers and ever smokers, lower BMD in lumbar spine was found in the group of ever smokers (p=0.018). Patients reporting regular physical activity between age 15-19 years had higher BMD in lumbar spine than patients reporting inactivity or occasional activity in this period (p=0.021).
Conclusion: Reduced TBS was not prevalent in patients with MS, suggesting that BMD alone, and not the bone microarchitecture, is affected in patients with MS. As in the background population avoiding smoking, performing regular physical activity and maintaining a normal BMI in late adolescence likely contribute to a better bone health in MS.
Disclosure:
Anna Gabriella Olsson has received support for congress participation from Biogen Idec, Novartis, Roche and Teva.
Helle Bach Søndergaard has received support for congress participation from Biogen Idec, Genzyme and Teva.
Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck Serono, Novartis and Teva.
Peter Sandor Oturai: nothing to disclose.
Annette Bang Oturai has served on scientific advisory boards for Biogen Idec; has received research support from Novartis and Biogen Idec; has received speaker honoraria from Biogen Idec, Novartis and TEVA; and has received support for congress participation from, Merck Serono, TEVA, Biogen, Novartis and Genzyme.
Abstract: P319
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: MS patients are at increased risk of reduced bone mineral density (BMD) and fractures. To date, the etiology of bone loss in MS is unclear. As we previously reported (Olsson et al. MS Journal 2015), age, body mass index (BMI) and disease severity were the principal factors associated with reduced BMD in our cohort. Trabecular bone score (TBS) is a recently developed analytical tool that provides a measurement of the three-dimensional bone microarchitecture. Decreased TBS predicts an increased fracture risk independently of BMD. To date, no studies have investigated the TBS in MS patients.
Objectives: To assess bone quality in MS patients by TBS and to evaluate potential risk factors that may affect BMD and TBS in patients with MS.
Methods: 260 patients from the Danish MS Center were included in the study. Data on BMD - measured by dual x-ray absorptiometry (DXA) in the period 2012 to 2013 - were previously published. The antero-posterior spine images from these scans were reanalysed and TBS was calculated using the TBS iNsight software (MediMaps®, Merignac, France). Students t-test and univariate regression analyses were performed with additional information on smoking, alcohol, sun exposure, physical activity, diet, BMI at year 20, and vitamin D supplements - all parameters were obtained from questionnaires. Disease severity was assessed by the Expanded Disability Status Scale (EDSS).
Results: The TBS values were not significantly different from those of an age-matched reference population. Low TBS was associated with high age (p< 0.0001) and high EDSS (p=0.021). Low BMI at 20 years of age was associated with low BMD in both lumbar spine (p=0.016) and femur (p< 0.005). Neither the number of smoking pack-years nor alcohol consumption was associated with BMD. When dichotomized into never smokers and ever smokers, lower BMD in lumbar spine was found in the group of ever smokers (p=0.018). Patients reporting regular physical activity between age 15-19 years had higher BMD in lumbar spine than patients reporting inactivity or occasional activity in this period (p=0.021).
Conclusion: Reduced TBS was not prevalent in patients with MS, suggesting that BMD alone, and not the bone microarchitecture, is affected in patients with MS. As in the background population avoiding smoking, performing regular physical activity and maintaining a normal BMI in late adolescence likely contribute to a better bone health in MS.
Disclosure:
Anna Gabriella Olsson has received support for congress participation from Biogen Idec, Novartis, Roche and Teva.
Helle Bach Søndergaard has received support for congress participation from Biogen Idec, Genzyme and Teva.
Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck Serono, Novartis and Teva.
Peter Sandor Oturai: nothing to disclose.
Annette Bang Oturai has served on scientific advisory boards for Biogen Idec; has received research support from Novartis and Biogen Idec; has received speaker honoraria from Biogen Idec, Novartis and TEVA; and has received support for congress participation from, Merck Serono, TEVA, Biogen, Novartis and Genzyme.