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2013 Research Abstract

The Role of Multiple Sclerosis as a Risk Factor for the Development of Osteoporosis

Investigators: Christopher Perrone, Christine Foley, Linda Churchill, Sybil Crawford, PhD, Judith Ockene, PhD, MEd

Mentor: Carolina Ionete, MD, PhD

Background: Osteoporosis is common among women with multiple sclerosis (MS), though the temporal relationship has not been studied. Data from the Women’s Health Initiative (WHI) provides an opportunity to examine the risk of developing osteoporosis in longstanding MS.

Objectives: This study aims to understand the relationship between MS and osteoporosis, clarifying the impact of pharmacologic and lifestyle factors.

Methods: From the WHI dataset, the sample included 449 women reporting MS at baseline and 152,432 women without MS as a control group. Baseline measures of self-reported osteoporosis, age, smoking status, steroid and anti-inflammatory use, and supplementary as well as dietary calcium and vitamin D were compared. Proportional hazards modeling was performed on follow-up data to monitor for incident osteoporosis and to factor out associations of additional measures. Type of treatment and time-to-use of osteoporosis-related medications were also compared between MS and control groups.

Results: At baseline, women with MS are three times as likely to report osteoporosis (p<0.0001), are younger, have more likely smoked, and consume less supplemental calcium. In follow-up, age, education, body mass index, smoking, hormone use, steroid use, dietary calcium and vitamin D, and recreational activity were associated with both MS and osteoporosis. After accounting for these shared relationships in proportional hazards modeling, reported diagnosis of MS was not significantly associated with a new diagnosis of osteoporosis at the end of the WHI study (p=0.17). No significant differences were observed in latency to osteoporosis or treatment.

Conclusions: A higher prevalence of osteoporosis at baseline was found in participants reporting MS. This finding suggests that MS may significantly increase the risk of premenopausal osteoporosis while pharmacologic and lifestyle variables have a more significant role in post- menopausal osteoporosis.

Updated on July 3, 2014.