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Spinal bone mineral density, IGF-1 and IGFBP-3 in children with cerebral palsy
Omar Ali1, Melanie Shim, Eileen Fowler
1Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Insights
Childhood cerebral palsy (CP) is linked to osteopenia. This study found reduced spinal bone mineral density (BMD) and lower insulin-like growth factor (IGF-1) and IGFBP-3 levels in children with CP.
Area of Science:
- Pediatric endocrinology
- Bone metabolism research
- Neuromuscular disorders
Background:
- Childhood cerebral palsy (CP) is frequently associated with osteopenia.
- The growth hormone-IGF axis significantly influences bone metabolism.
Purpose of the Study:
- To investigate the relationship between spinal bone mineral density (BMD) and serum IGF-1 and IGFBP-3 levels in children with CP.
Main Methods:
- A cross-sectional study involved 30 children (ages 4.5-15) diagnosed with CP.
- Dual-energy x-ray absorptiometry (DXA) scans assessed spinal BMD.
- Serum levels of IGF-1, IGFBP-3, calcium, phosphorus, PTH, vitamin D, and osteocalcin were measured, along with urinary N-telopeptide.
Main Results:
- Children with CP exhibited decreased spinal BMD (average Z-score -2.14) compared to norms.
- Serum IGF-1 (Z-score -0.74) and IGFBP-3 (Z-score -0.68) levels were also reduced.
- A significant correlation was observed between spinal BMD and IGFBP-3 levels (r=0.386, p=0.05) in children with osteopenia.
Conclusions:
- Osteopenia is prevalent in children with CP.
- Lower IGF-1 and IGFBP-3 levels may be associated with osteopenia in this population.
Background/Aims:
Childhood cerebral palsy (CP) is associated with osteopenia and the GH-IGF axis plays an important role in bone metabolism. We studied the relationship between spinal bone mineral density (BMD) and serum IGF-1 and IGFBP-3 in children with CP.
Methods:
Cross-sectional study of 30 children (9 F and 21 M, ages 4.5-15) with CP. Subjects underwent dual-energy x-ray absorptiometry scans (spinal BMD), blood tests (IGF-1, IGFBP-3, Ca, P, PTH, vitamin D, osteocalcin) and urine tests (N-telopeptide).
Results:
Spinal BMD was decreased in children with CP (average Z-score -2.14 +/- 1.08) compared to age- and gender-matched norms. IGF-1 and IGFBP-3 were also decreased compared to age-matched norms (average IGF-1 Z-score -0.74 +/- 1.2, average IGFBP-3 Z-score -0.68 +/- 1.2). All other blood and urine tests, including measures of calcium and vitamin D status, were normal. In 25 CP children with osteopenia (Z-score >-1), there was a trend towards correlation between spinal BMD Z-score and serum IGF-1 SDS score (r = 0.328, p = 0.09). IGFBP-3 Z-scores were available in 24 of these patients and had a statistically significant correlation with spinal BMD Z-score (r = 0.386, p = 0.05).
Conclusion:
Osteopenia is common in children withCP and may be associated with lower IGF-1 and IGFBP-3 levels.
