Risk of bone loss in men with multiple sclerosis

Context: O steoporosis and the increased fracture r isk associated with osteoporosis become apparent in men appro ximately 10 years later than women. However, in recent studies, appro ximately 20 % of healthy men in the age range 55¡/64 years were found to be osteopenic. Emerging data suggest a significantly increased prevalence of osteoporosis in men and women with multiple sclerosis (MS) compared to age-matched controls, but no specific clinical testing recommendations are available for men. Objective: To determine the proportion of male MS patients with osteopo rosis and to identify the factors associated with the reduction in bone mass. Design: C onsecutive male MS patients seen at our MS clinic were screened with dual-X-ray absorptiometry (DEXA) scan for determining the bone mineral density (BMD). A ll patients had neuro logical Expanded Disability Status Scale (EDSS) evaluation. The results were compared to healthy age-matched male reference population using the Z score and to a cohort of women MS patients and women contro ls. C alcium, to tal testo sterone, sex-ho rmone binding globulin (SHBG), 25-hydro xy-vitamin-D, and parathyroid hormone (PTH) were evaluated in male patients with decreased BMD. Relevant data on body mass index (BMI), medicatio n, alcohol consumption, smoking, and sexual dysfunction were reco rded. Setting: Academic MS C entre. Patients and other participants: For ty consecutive male MS patients, age mean 51.29/8.7 years, and mean EDSS of 5.89/1.9 were evaluated with DEXA scan. O f these, 17.5 % patients were relapsing¡