Abstract
BackgroundPeople with multiple sclerosis have high risk of osteoporosis and fractures. A poor vitamin D status is a risk factor for MS, and vitamin D supplementation has been recommended both to prevent MS progression and to maintain bone health.MethodsWe assessed the effect of 20,000 IU vitamin D3 weekly compared to placebo on biochemical markers of bone metabolism in 68 persons with relapsing remitting multiple sclerosis.ResultsSerum levels of 25-hydroxyvitamin D more than doubled in the vitamin D group, and parathyroid hormone decreased in the vitamin D group compared to the placebo group at week 48 and week 96. There was however no effect on bone formation as measured by procollagen type I N propeptide (PINP), or on bone resorption as measured by C-terminal cross-linking telopeptide of type I collagen (CTX1). Neither PINP nor CTX1 predicted bone loss from baseline to week 96.ConclusionsThese findings corroborate the previously reported lack of effect of weekly high dose vitamin D supplementation on bone mass density in the same patients, and suggest that such vitamin D supplementation does not prevent bone loss in persons with MS who are not vitamin D deficient.Trial registrationThe trial was registered at ClinicalTrials.gov on April 4 2008, registration number NCT00785473.
Highlights
People with multiple sclerosis have high risk of osteoporosis and fractures
We have previously reported a randomized controlled trial (RCT) of weekly supplementation with 20,000 IU vitamin D3 compared to placebo in fully ambulatory persons with relapsing remitting multiple sclerosis (MS) living above the Arctic Circle [21]
The aim of the current study was to examine if CTX and procollagen type I N propeptide (PINP) predict bone loss, and if vitamin D3 supplementation affect these markers of bone formation and turnover in persons with MS
Summary
People with multiple sclerosis have high risk of osteoporosis and fractures. Low levels of vitamin D are associated with increased future risk of developing multiple sclerosis and with increased disease activity [1,2,3]. Several studies have shown that people with multiple sclerosis (MS) are at increased risk of developing osteoporosis [4, 5]. The combination of osteoporosis and high risk of falling may add to the burden of disease through increased risk of fractures. Large population based studies have shown that persons with MS have a marked increase of fractures compared to the general population [8,9,10,11,12]. Data from the Danish MS Registry and The National Hospital Discharge Registry showed that the risk of fractures of tibia, hip and femur in persons with MS was three to six times higher than in the general population [10]
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