Introduction: Bone mineral density (BMD) was known to be lower in multiple sclerosis (MS) patients at both the lumbar spine and hip. Several factors have been shown to be related to osteoporosis and MS including Matrix metalloproteinase 9 (MMP-9), Osteopontin (OPN), Osteocalcin (OC), receptor activator of nuclear factor Kappa-B ligand (RANKL), osteoprotegrin (OPG), C-reactive protein (CRP), PTH and Vitamin D. Interfron beta-1b (IFN beta 1-b) is one of the medications that is applied in the management of MS and has been shown to ameliorate disease activity and inhibit osteoporesis. The aim of this study was to investigate the effects of IFN-1b1 and IFN-1ba plus Ca-Vit D3 on BMD, EDSS and the abovementioned factors in MS patients.Methods: Thirty-six patients with chronic progressive MS who have been receiving IFN beta-1b or IFN beta-1b plus VitD3-Ca were enrolled as a target group and 38 age and sex matched cases were considerated as a control group in the study. The level of serum CRP, MMP-9, OPN, OC, RANKL and OPG were investigated by ELISA. BMD was measured by dual-energy x-ray absorptiometery.Results: BMD of L4 were lower in MS patients receiving IFN beta-1b or IFN beta-1b and VitD3-Ca in comparison to control (p<0.01), but there were no significant difference in BMD of femur neck, wards triangle, greater trochanter, L2, L3, L4 and total lumbar. We did not observe any difference in hsCRP, MMP-9, OPN, OPG, RANKL, OC and Vit D3. However PTH levels were significantly lower in MS patients receiving IFN-1ba plus Ca-Vit D3 compared to control (P<0.05). Multiple linear regressions revealed that BMI was positively correlated with BMD in femur neck (b=0.27; p=0.026), greater trochanter (b=0.32; p=0.007), L2 (b=0.31; p=0.01), L4 (b=0.4; p=0.0) and lumbar (b=0.4; p=0.001). In multivariate linear analysis, after BMD adjustment for BMI as covariate, it was observed that OPG were independent predictor of BMD in L4 (r2=0.78; p=0.02) and Lumbar (r2=0.74; p=0.03), MMP-9 was correlate with lumbar BMD (r2=0.731; p=0.046), and PTH with BMD L3 (0.647; p=0.008).Conclusion: We found that patients receiving IFN-1b1 or IFN-1ba plus Ca-Vit D3 show ameliorated BMD and other factors associated with osteoporosis in MS.

Background: Vitamin D deficiency is prevalent among Indian women. Subclinical vitamin D deficiency is a significant risk factor for osteopenia and fractures. However, its effect on bone metabolism and bone mineral density (BMD) is still debatable. Objectives: This study aimed to determine relationships of the vitamin D status with bone turnover markers, carboxy-terminal telopeptide of type-I collagen (CTX), N-terminal propeptide of type I procollagen (PINP), and BMD in healthy Indian women. Methods: In this cross-sectional study, we determined serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone, serum CTX, and PINP using commercial ELISA kits in 310 healthy Indian women aged 25-65 years who underwent BMD measurements with DXA scan. Results: The prevalence of vitamin D deficiency was 53. 87% and vitamin D insufficiency 31. 29%. A direct correlation of BMD with vitamin D levels was not observed. PINP negatively correlated with vitamin D in both premenopausal (Spearman’ s r =-0. 169, P < 0. 05) and postmenopausal (Spearman’ s r =-0. 241, P < 0. 05) women. However, CTX positively correlated with vitamin D in both premenopausal (Spearman’ s r = 0. 228, P < 0. 01) and postmenopausal (Spearman’ s r = 0. 244, P < 0. 05) women. Conclusions: Vitamin D deficiency is more prevalent in premenopausal women than in postmenopausal ones. Although vitamin D does not show any association with BMD, it affects bone remodeling, which is reflected by changes in the bone formation marker PINP and the bone resorption marker CTX.