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Published on: January 29, 2018
Evaluation of bone mineral density in children with cerebral palsy
Bülent Unay1, S Umit Sarici, Sabahattin Vurucu
1Department of Pediatrics, Gülhane Military Medical Academy, Ankara, Turkey.
Insights
Children with cerebral palsy have lower bone mineral density than healthy peers. Factors like ambulation and physical therapy did not significantly impact bone density in this study, highlighting the need for further research into causes and fracture risks.
Area of Science:
- Pediatrics
- Orthopedics
- Metabolic Bone Disease
Background:
- Cerebral palsy (CP) is associated with various health complications, including potential impacts on bone health.
- Reduced bone mineral density (BMD) in children with CP increases the risk of pathological fractures.
Purpose of the Study:
- To investigate bone mineral density (BMD) in children with cerebral palsy (CP) compared to healthy controls.
- To examine the influence of risk factors such as ambulation status, nutritional intake, and physical therapy on BMD in children with CP.
Main Methods:
- A comparative study involving 40 children with CP and 40 age-matched healthy children.
- Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA) at the L2-L4 lumbar vertebrae.
- Assessment of risk factors included weight, height, body-mass index, serum calcium, phosphorus, alkaline phosphatase, 25 OH vitamin D, ambulation status, nutritional intake, and physical therapy participation.
Main Results:
- Children with CP exhibited significantly lower mean BMD at the lumbar spine compared to the control group (p<0.05).
- No significant differences in BMD were observed based on ambulation status, calcium/energy intake, or regular physical therapy participation.
- Serum levels of calcium, phosphorus, alkaline phosphatase, and 25 OH vitamin D did not differ significantly between groups.
Conclusions:
- Children with cerebral palsy demonstrate reduced bone mineral density, independent of common risk factors like ambulation, nutrition, and physical therapy in this cohort.
- The specific mechanisms underlying reduced BMD in pediatric CP require further investigation.
- Future large-scale studies are warranted to understand the etiology of low BMD in CP and mitigate fracture risk.
Abstract:
In the present study, bone mineral density of 40 children with cerebral palsy (study group) and the effects of various risk factors on bone mineralization in these children were investigated by comparing with 40 age-matched healthy children (control group). Weight, height, skinfold thickness, body-mass index measurements, and serum levels of calcium, phosphorus, alkaline phosphatase and 25 OH vitamin D were not significantly different between the study and control groups (p>0.05). The mean bone mineral density value of the study group measured by dual-energy X-ray absorptiometry method at L2-L4 levels of lumbar vertebrae was significantly lower than that of the control group (p<0.05). When the patients in the study group were assessed with respect to ambulation status, pattern of involvement, calcium and energy intakes, and whether or not they had taken and/or were taking a regular physical therapy program, there was a significant difference only between the hemiplegic and tetraplegic patients (p<0.05), while there were no significant differences among the patients who were ambulant versus non-ambulant, who had sufficient versus insufficient calcium and energy intakes, and who did and did not take a regular physical therapy (p>0.05). Although the ambulatory status, quantity of calcium and energy intakes, and the presence or absence of a physical therapy program had no effects on bone mineral density values of the children with cerebral palsy in this study, the exact factors and mechanisms responsible for the reduced bone mineral density in children with cerebral palsy should be investigated in further large-scale studies considering the increased risk of pathological fractures in these patients.
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