Longitudinal changes in bone density in adolescents and young adults with cerebral palsy: A case for early intervention.
bone density
cerebral palsy
fracture
longitudinal
osteoporosis
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
11
04
2019
revised:
20
06
2019
accepted:
24
06
2019
pubmed:
28
6
2019
medline:
15
9
2020
entrez:
28
6
2019
Statut:
ppublish
Résumé
Cerebral palsy (CP) is a motor disorder affecting movement, muscle tone and posture due to damage to the foetal or infant brain. The subsequent lack of ambulation, nutritional deficiencies, anticonvulsant use and hormonal deficiencies have been implicated in the low bone mass associated with this condition. To assess changes in areal bone mineral density (aBMD) during adolescence and young adulthood in individuals with CP. The effect of ambulation, nutrition, hypogonadism on longitudinal changes in aBMD is also examined. Retrospective longitudinal study. Forty-five subjects with CP who had longitudinal dual-energy X-ray absorptiometry (DXA) scans at a single tertiary hospital between 2006 and 2018. Mean age at first DXA was 19.4 years (range: 10-36 years), 57.8% were male and 80% were nonambulatory. The mean Z-scores at baseline were <-2.0 at all sites - lumbar spine (LS), femoral neck (FN), total hip (TH) and total body (TB). The median change in aBMD was +1.2%-1.9% per year in all subjects but in those <20 years of age, the median change was 4%-8% per year. Z-scores across all sites remained stable over time. Reduced functional state as measured by the gross motor functional classification scale (GMFCS) had a small negative effect on aBMD over time. In adolescents with CP, low bone mass was evident from the baseline DXA. However, significant bone accrual occurred during the second decade, followed by bone maintenance in young adulthood. Future studies should focus on optimizing bone health from early childhood.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
517-524Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Hemming K, Hutton JL, Pharoah PO. Long-term survival for a cohort of adults with cerebral palsy. Dev Med Child Neurol. 2006;48(2):90-95.
Bottos M, Feliciangeli A, Sciuto L, Gericke C, Vianello A. Functional status of adults with cerebral palsy and implications for treatment of children. Dev Med Child Neurol. 2001;43(8):516-528.
Murphy KP, Molnar GE, Lankasky K. Employment and social issues in adults with cerebral palsy. Arch Phys Med Rehabil. 2000;81(6):807-811.
Sheridan KJ. Osteoporosis in adults with cerebral palsy. Dev Med Child Neurol. 2009;51(Suppl 4):38-51.
Cremer N, Hurvitz EA, Peterson MD. Multimorbidity in Middle-Aged Adults with Cerebral Palsy. Am J Med. 2017;130(6):744.e9-744.e15.
Trinh A, Wong P, Fahey MC, et al. Musculoskeletal and endocrine health in adults with cerebral palsy: new opportunities for intervention. J Clin Endocrinol Metab. 2016;101(3):1190-1197.
Fowler EG, Rao S, Nattiv A, Heberer K, Oppenheim WL. Bone density in premenopausal women and men under 50 years of age with cerebral palsy. Arch Phys Med Rehabil. 2015;96(7):1304-1309.
Yoon YK, Kim AR, Kim OY, Lee K, Suh YJ, Cho SR. Factors affecting bone mineral density in adults with cerebral palsy. Ann Rehabil Med. 2012;36(6):770-775.
Marciniak C, Gabet J, Lee J, Ma M, Brander K, Wysocki N. Osteoporosis in adults with cerebral palsy: feasibility of DXA screening and risk factors for low bone density. Osteoporos Int. 2016;27(4):1477-1484.
Kim W, Lee SJ, Yoon YK, Shin YK, Cho SR, Rhee Y. Adults with spastic cerebral palsy have lower bone mass than those with dyskinetic cerebral palsy. Bone. 2015;71:89-93.
Henderson RC, Kairalla JA, Barrington JW, Abbas A, Stevenson RD. Longitudinal changes in bone density in children and adolescents with moderate to severe cerebral palsy. J Pediatr. 2005;146(6):769-775.
Grossberg R, Blackford MG, Kecskemethy HH, Henderson R, Reed MD. Longitudinal assessment of bone growth and development in a facility-based population of young adults with cerebral palsy. Dev Med Child Neurol. 2015;57(11):1064-1069.
Carel JC, Leger J. Clinical practice. Precocious puberty. N Engl J Med. 2008;358(22):2366-2377.
Adult Official Positions of the International Society of Clinical Densitometry 2015. https://iscd.app.box.com/OP-ISCD-2015-Adult-Eng. Accessed February 12, 2019.
Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-223.
Modlesky CM, Whitney DG, Singh H, Barbe MF, Kirby JT, Miller F. Underdevelopment of trabecular bone microarchitecture in the distal femur of nonambulatory children with cerebral palsy becomes more pronounced with distance from the growth plate. Osteoporos Int. 2015;26(2):505-512.
Wright CM, Reynolds L, Ingram E, Cole TJ, Brooks J. Validation of US cerebral palsy growth charts using a UK cohort. Dev Med Child Neurol. 2017;59(9):933-938.
Crabtree NJ, Arabi A, Bachrach LK, et al. Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD Pediatric Official Positions. J Clin Densitom. 2014;17(2):225-242.
Henderson RC, Berglund LM, May R, et al. The relationship between fractures and DXA measures of BMD in the distal femur of children and adolescents with cerebral palsy or muscular dystrophy. J Bone Miner Res. 2010;25(3):520-526.
Berger C, Goltzman D, Langsetmo L, et al. Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res. 2010;25(9):1948-1957.
Modlesky CM, Kanoff SA, Johnson DL, Subramanian P, Miller F. Evaluation of the femoral midshaft in children with cerebral palsy using magnetic resonance imaging. Osteoporos Int. 2009;20(4):609-615.
Howard J, Soo B, Graham HK, et al. Cerebral palsy in Victoria: motor types, topography and gross motor function. J Paediatr Child Health. 2005;41(9-10):479-483.
Ott SM, O'Hanlan M, Lipkin EW, Newell-Morris L. Evaluation of vertebral volumetric vs. areal bone mineral density during growth. Bone. 1997;20(6):553-556.
Wren TA, Liu X, Pitukcheewanont P, Gilsanz V. Bone acquisition in healthy children and adolescents: comparisons of dual-energy X-ray absorptiometry and computed tomography measures. J Clin Endocrinol Metab. 2005;90(4):1925-1928.