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Bone Health in Patients with Multiple Sclerosis英文文献资料.doc

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Bone Health in Patients with Multiple Sclerosis英文文献资料

SAGE-HindawiAccesstoResearch JournalofOsteoporosis Volume2011,ArticleID596294,9pages doi:10.4061/2011/596294 ReviewArticle BoneHealthinPatientswithMultipleSclerosis VitZikan DepartmentofInternalMedicine3,FacultyofMedicine1,CharlesUniversity,12800Prague,CzechRepublic CorrespondenceshouldbeaddressedtoVitZikan,vitzikan@ Received12October2010;Accepted2February2011 AcademicEditor:TomaszMiazgowski Copyright?2011VitZikan.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense,which permitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Multiple sclerosis (MS) is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability.PatientswithMShavemultipleriskfactorsforosteoporoticfractures,suchasprogressiveimmobilization,long-term glucocorticoids(GCs)treatmentorvitaminDde?ciency.Thedurationofmotordisabilityappearstobeamajorcontributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorptionwithdepressedboneformationandamarkeddisruptionofmechanosensorynetworkoftightlyconnectedosteocytes duetoincreaseofosteocyteapoptosis.Patientswithhigherlevelofdisabilityhavealsohigherriskoffallsthatcombinedwith abonelossincreasesthefrequencyofbonefractures.Therearecurrentlynorecommendationshowtobestpreventandtreat osteoporosisinpatientswithMS.However,devastatinge?ectofimmobilizationontheskeletoninpatientswithMSunderscores theimportanceofadequatemechanicalstimuliformaintainingthebonestructureanditsmechanicalcompetence.Thephysical aswellaspharmacologicalinterventionswhichcancounteracttheboneremodelingimbalance,particularlyosteocyteapoptosis, willbepromisingforpreventionandtreatmentofosteoporosisinpatientswithMS. 1.Introduction poor balance, muscle weakness, fatigue, and progressive immobilization [4]. The resultant functional impairments leadtofrequentlyfalls[5].Thediseasea?ectsmainlyyoung adults(20to40years)andit