Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis
Yıl: 2020 Cilt: 26 Sayı: 2 Sayfa Aralığı: 115 - 120 Metin Dili: İngilizce DOI: 10.4274/tod.galenos.2020.98700 İndeks Tarihi: 25-11-2020
Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis
Öz: Objective: Osteoporosis (OP) is one of the most frequent metabolic bone disorders worldwide, male OP is still underestimated and undertreated. Primary progressive multiple sclerosis (PPMS) is considered as an important cause of secondary OP in males and there is limited data on this condition in Turkey. This study aimed to evaluate the bone mineral density (BMD) of male PPMS patients and the possible clinical and laboratory interacting factors as well as to also define the correlation between BMD and bone turnover markers (BTM).Materials and Methods: In this study, 26 male PPMS patients and 20 age-matched healthy volunteers were evaluated by the Expanded Disability Status Scale (EDSS), femoral and lumbar BMD, biochemical and hormonal tests and BTMs.Results: Demographic characteristics were statistically similar between the groups. Mean values for patient age, disease duration and EDSS score were 42.5±10.0 years, 3.5±1.5 years and 4.6±1.6, respectively. Although we found a significant difference in BMD and carboxy-terminal telopeptide levels between PPMS patients and the control group, there were no significant correlations between sex hormone binding globülin levels, EDSS, BMD scores, BTMs and other biochemical variables.Conclusion: BMD scores were lower in the patient group compared to the control group. This study highlights the importance of considering bone health in male PPMS patients and reminds that strategies should be developed as part of the management plan.
Anahtar Kelime: Primer Progresif Multipl Sklerozlu Erkek Hastalarda Kemik Mineral Yoğunluğunu Etkileyen Faktörler
Öz: Amaç: Osteoporoz (OP) dünya çapında en sık görülen metabolik kemik bozukluklarından biri olmasına rağmen, erkek OP’si halen yeterince göz önüne alınmamakta ve tedavi edilmemektedir. Primer progresif multipl skleroz (PPMS), erkeklerde ikincil OP’nin önemli bir nedeni olarak kabul edilmekte olup, Türkiye’de konu ile ilgili veriler sınırlıdır. Bu araştırmada erkek PPMS hastalarının kemik mineral yoğunluklarının (KMY) incelenmesi, etkileşen olası klinik ve laboratuvar faktörlerin saptanması ve ayrıca KMY ile biyokimyasal kemik döngü belirteçleri (BKDB) arasındaki korelasyonun tanımlanması amaçlanmıştır. Gereç ve Yöntem: Yirmi altı erkek PPMS hastası ve 20 yaş uyumlu sağlıklı gönüllü Genişlemiş Özürlülük Durum Ölçeği (EDSS), femoral ve lomber KMY, biyokimyasal ve hormonal testler ve BKDB ile değerlendirildi. Bulgular: Demografik özellikler gruplar arasında istatistiksel olarak benzerdi. Hastaların yaş, hastalık süresi ve EDSS skoru için ortalama değerler sırasıyla 42,5±10,0 yıl, 3,5±1,5 yıl ve 4,6±1,6 idi. PPMS hastaları ile kontrol grubu arasında KMY ve karboksi terminal telopeptid düzeylerinde anlamlı bir fark bulunmuş olsa da cinsiyet hormonu bağlayıcı globulin düzeyleri, EDSS, KMY skorları, BKDB’ler ve diğer biyokimyasal değişkenler arasında anlamlı korelasyon saptanmadı. Sonuç: KMY skorlarının hasta grubunda kontrol grubuna göre daha düşük olduğu belirlendi. Bu çalışma erkek PPMS hastalarında kemik sağlığının göz önünde bulundurmanın önemini vurgulamakta ve tedavi planının stratejik bir parçası olarak ele alınması gerektiğini hatırlatmaktadır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Tarantino U, Iolascon G, Cianferotti L, Masi L, Marcucci G, Giusti F, et al. Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology. J Orthop Traumatol 2017;18(Suppl 1):S3-S36.
- 2. Khosla S, Amin S, Orwoll E. Osteoporosis in men. Endocr Rev 2008; 29:441-64.
- 3. Painter SE, Kleerekoper M, Camacho PM. Secondary osteoporosis: a review of the recent evidence. Endocr Pract 2006;12:436-45.
- 4. Steffensen LH, Mellgren SI, Kampman MT. Predictors and prevalence of low bone mineral density in full ambulatory persons with multiple sclerosis. J Neurol 2010;257:410-8.
- 5. Drake MT, Murad MH, Mauck KF, Lane MA, Undavalli C, Elraiyah T, et al. Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 2012;97:1861-70.
- 6. Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J. Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Osteoporos Int 2000;11 Suppl 6:S2-17.
- 7. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69:292-302.
- 8. Kurtzke J F. On the Origin of EDSS. Mult Scler Relat Disord 2015;4:95-103.
- 9. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994;843:1-129.
- 10. Writing Group for the ISCD Position Development Conference. Diagnosis of Osteoporosis in Men, Premenopausal Women, and Children. J Clin Densitom 2004;7:17-26.
- 11. Zikan V. Bone Health in Patients with Multiple Sclerosis. J Osteoporos 2011;2011:596294.
- 12. Laet CD, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005;16:1330-8.
- 13. Formica CA, Cosman F, Nieveas J, Herbert J, Lindsay R. Reduced bone mass and fat-free mass in women with multiple sclerosis: effects of ambulatory status and glucocorticoid use. Caicif Tissue Int 1997;61:129-33.
- 14. Tüzün S, Altintaş A, Karacan I, Tangürek S, Saip S, Siva A. Bone status in multiple sclerosis: beyond corticosteroids. Mult Scler 2003;9:600-4.
- 15. Nickersonan M, Cofieldb SS, Tyryc T, Salterb AR, Cutterb GR, Marrie RA. Impact of multiple sclerosis relapse: The NARCOMS participant perspective. Mult Scler Relat Disord 2015;4:234-40.
- 16. Weinstock-Guttman B, Gallagher E, Baier M, Green L, Feichter J, Patrick K, et al. Risk of bone loss in men with multiple sclerosis. Mult Scler 2004;10:170-5.
- 17. Hearn AP, Silber E. Osteoporosis in multiple sclerosis. Mult. Scler 2010;16:1031-43.
- 18. Forwood MR. Mechanical effects on the skeleton: Are there clinical implications? Osteoporosis Int 2001;12:77-83.
- 19. Zikan V, Týblová M, Raška I Jr, Havrdová E, Luchavová M, Michalská D, et al. Bone mineral density and body composition in men with multiple sclerosis chronically treated with low-dose glucocorticoids. Physiol Res 2012;61:405-17.
- 20. Schwid SR, Goodman AD, Puzas JE, McDermott MP, Mattson DH. Sporadic corticosteroid pulses and osteoporosis in multiple sclerosis. Arch Neurol 1996;53:753-7.
- 21. Nordström P, Petterson U, Lorentzon R. Correlation of bone density to strength and physical activity in young men with a low or moderate level of physical activity. Calcif Tissue Int 1997;60:332-7.
- 22. Düppe H, Gardsell P, Johnell O, Nilsson BE, Ringberg K. Bone mineral density, muscle strength and physical activity. A population-based study of 332 subjects aged 15-42 years. Acta Orthop Scand 1997;68:97-103.
- 23. Gibson JC, Summers GD. Bone health in multiple sclerosis. Osteoporos Int 2011;22:2935-49.
- 24. Olsson A, Oturai DB, Sorensen PS, Oturai PS, Oturai AB. Short-term, high-dose glucocorticoid treatment does not contribute to reduced bone mineral density in patients with multiple sclerosis. Mult Scler 2015;21:1557-65.
- 25. Gupta S, Ahsan I, Mahfooz N, Abdelhamid N, Ramanathan M, Weinstock-Guttman B. Osteoporosis and multiple sclerosis: risk factors, pathophysiology, and therapeutic interventions. CNS Drugs 2014;28:731-42.
- 26. Azin A, Mohammad T, Shahriar N. Factors affecting bone mineral density in multiple sclerosis patients. Ir J Neurol 2013;12:19-22.
- 27. Ciccone A, Beretta S, Brusaferri F, Galea I, Protti A, Spreafico C. Corticosteroids for the long-term treatment in multiple sclerosis. Cochrane Database Syst Rev 2008;23:1-7.
- 28. Schwid SR, Goodman AD, Puzas JE, McDermott MP, Mattson DH. Sporadic corticosteroid pulses and osteoporosis in multiple sclerosis. Arch Neurol 1996;53:753-7.
- 29. Kirbas A, Kirbas S, Anlar O, Turkyilmaz AK, Cure MC, Efe H. Investigation of the relationship between vitamin D and bone mineral density in newly diagnosed multiple sclerosis. Acta Neurol Belg 2013;113:43-7.
- 30. Stepan JJ, Havrdová E, Týblová M, Horáková D, Tichá V, Nováková I, et al. Markers of bone remodeling predict rate of bone loss in multiple sclerosis patients treated with low-dose glucocorticoids. Clin Chim Acta 2004;348:147-54.
- 31. Naylor KE, Jacques RM, Paggiosi M, Gossiel F, Peel NFA, McCloskey EV, et al. Response of bone turnover markers to three oral bisphosphonate therapies in postmenopausal osteoporosis: the TRIO study. Osteoporos Int 2016;27:21-31.
| APA | Çalışkan A, Gokce Kutsal F, Acar Ozen N, Akbıyık F, Karahan S, Karabudak R (2020). Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. , 115 - 120. 10.4274/tod.galenos.2020.98700 |
| Chicago | Çalışkan Aslı,Gokce Kutsal F. Yesim,Acar Ozen Nazire Pinar,Akbıyık Filiz,Karahan Sevilay,Karabudak Rana Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. (2020): 115 - 120. 10.4274/tod.galenos.2020.98700 |
| MLA | Çalışkan Aslı,Gokce Kutsal F. Yesim,Acar Ozen Nazire Pinar,Akbıyık Filiz,Karahan Sevilay,Karabudak Rana Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. , 2020, ss.115 - 120. 10.4274/tod.galenos.2020.98700 |
| AMA | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. . 2020; 115 - 120. 10.4274/tod.galenos.2020.98700 |
| Vancouver | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. . 2020; 115 - 120. 10.4274/tod.galenos.2020.98700 |
| IEEE | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R "Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis." , ss.115 - 120, 2020. 10.4274/tod.galenos.2020.98700 |
| ISNAD | Çalışkan, Aslı vd. "Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis". (2020), 115-120. https://doi.org/10.4274/tod.galenos.2020.98700 |
| APA | Çalışkan A, Gokce Kutsal F, Acar Ozen N, Akbıyık F, Karahan S, Karabudak R (2020). Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. Türk Osteoporoz Dergisi, 26(2), 115 - 120. 10.4274/tod.galenos.2020.98700 |
| Chicago | Çalışkan Aslı,Gokce Kutsal F. Yesim,Acar Ozen Nazire Pinar,Akbıyık Filiz,Karahan Sevilay,Karabudak Rana Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. Türk Osteoporoz Dergisi 26, no.2 (2020): 115 - 120. 10.4274/tod.galenos.2020.98700 |
| MLA | Çalışkan Aslı,Gokce Kutsal F. Yesim,Acar Ozen Nazire Pinar,Akbıyık Filiz,Karahan Sevilay,Karabudak Rana Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. Türk Osteoporoz Dergisi, vol.26, no.2, 2020, ss.115 - 120. 10.4274/tod.galenos.2020.98700 |
| AMA | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. Türk Osteoporoz Dergisi. 2020; 26(2): 115 - 120. 10.4274/tod.galenos.2020.98700 |
| Vancouver | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis. Türk Osteoporoz Dergisi. 2020; 26(2): 115 - 120. 10.4274/tod.galenos.2020.98700 |
| IEEE | Çalışkan A,Gokce Kutsal F,Acar Ozen N,Akbıyık F,Karahan S,Karabudak R "Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis." Türk Osteoporoz Dergisi, 26, ss.115 - 120, 2020. 10.4274/tod.galenos.2020.98700 |
| ISNAD | Çalışkan, Aslı vd. "Factors Affecting Bone Mineral Density in Male Patients with Primary Progressive Multiple Sclerosis". Türk Osteoporoz Dergisi 26/2 (2020), 115-120. https://doi.org/10.4274/tod.galenos.2020.98700 |
