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Bone mineral density and insulin-like growth factor-1 in children with spastic cerebral palsy
Insights
Children with cerebral palsy (CP) experience reduced bone mineral density (BMD) and insulin-like growth factor-1 (IGF-1) levels, which worsen with CP severity. Low BMD and IGF-1 are linked to GMFCS level and anticonvulsant use.
Area of Science:
- Pediatric Endocrinology
- Orthopedics
- Neurology
Background:
- Children with cerebral palsy (CP) often exhibit impaired linear growth and reduced bone mineral density (BMD).
- Understanding factors affecting BMD in CP is crucial for managing skeletal health.
Purpose of the Study:
- To evaluate bone mineral density (BMD) in children with spastic cerebral palsy (CP).
- To assess the relationship between BMD and insulin-like growth factor-1 (IGF-1) levels in these children.
Main Methods:
- A cross-sectional study involving 58 children with spastic CP (ages 4-12) and 19 controls.
- Bone mineral density (BMD) measured using dual-energy x-ray absorptiometry (DXA).
- Serum levels of insulin-like growth factor-1 (IGF-1) and vitamin D assessed; patients classified by Gross Motor Function Classification System (GMFCS).
Main Results:
- Seven children (12.1%) reported fractures.
- IGF-1 levels and BMD were found to decrease with increasing CP severity.
- IGF-1 positively correlated with serum vitamin D, BMI, and BMD.
- Severe GMFCS levels or anticonvulsant use were associated with higher risk of low BMD and IGF-1.
Conclusions:
- Children with spastic CP show significantly lower BMD and IGF-1 levels.
- IGF-1 negatively correlates with osteopenia severity in spastic CP.
- Children with CP who are not independently ambulant, have severe GMFCS, or use anticonvulsants are at high risk for low BMD.
Background:
Children with cerebral palsy (CP) have significant decrease linear growth rate and low bone mineral density (BMD).
Aims:
This study is to evaluate BMD in children with CP and its relation to the levels of insulin-like growth factor-1 (IGF-1).
Subjects And Methods:
This cross-sectional study was carried out on 58 children suffering from spastic CP with the age range 4-12 years compared to 19 controls. All assessed by dual energy x-ray absorptiometry (DXA) to measure BMD, serum level of IGF-1, and serum vitamin D. The patients were classified according to their GMFCS.
Results:
Fractures were reported in seven (12.1%) of cases. Our study demonstrated that, IGF-1 level and BMD decrease in correlation with the severity of CP. IGF-1correlates positively with serum vitamin D, BMI, and BMD. CP children with severe GMFCS level or who use anticonvulsive drugs are at a high risk for low BMD and low levels of IGF-1.
Conclusion:
Both BMD and IGF-1 were significantly in low children with spastic CP; IGF-1 negatively correlates with the severity of osteopenia in children with spastic. Children with CP who are not independently ambulant or with severe GMFCS level or who use anticonvulsive drugs are at a high risk for developing low BMD.
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