Abstract

Low bone mineral density (BMD) is an emerging health issue in adults with cerebral palsy (CP). This cross-sectional study aimed to describe the characteristics of BMD in adults with CP, and to elucidate the risk factors for low BMD in this population. People aged ≥20 years and diagnosed with CP were recruited from February 2014 to November 2014. We assessed BMD using dual-energy X-ray absorptiometry (DXA) for the lumbar spine, femoral neck, and total femur. Moreover, the body composition was assessed using DXA. We included a total of 87 adults with CP (mean age 42.01 years; 52 men). The prevalence of low BMD was 25.3%. Male sex and age were associated with lower BMD. BMD was significantly lower in the non-ambulatory group than that in the ambulatory group for both lumbar spine and femoral neck. The total fat mass demonstrated a positive correlation with the Z-score and BMD for the femur neck and total femur. Body mass index (BMI) and total fat mass were positively correlated with BMD in the lumbar spine, femoral neck, and total femur. However, the Gross Motor Function Classification Scale levels were negatively correlated with BMD at the aforementioned three sites. In conclusion, adults with CP revealed decreased BMD, which was associated with male sex, age, decreased gross motor function, loss of ambulatory function, low BMI, decreased total fat mass, and decreased total fat-free mass.

Highlights

  • Low bone mineral density (BMD) is a common health issue in cerebral palsy (CP) [1, 2]

  • A total of 87 adults with CP were included in this study

  • Based on the T-scores, 24% of the participants and 64% of those older than 50 years were classified as having osteoporosis

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Summary

Introduction

Low bone mineral density (BMD) is a common health issue in cerebral palsy (CP) [1, 2]. Children with CP have lower BMD than their non-disabled counterparts [2]. Several causes, including decreased ambulation, insufficient vitamin D or calcium, or anticonvulsants, supposedly induce low BMD in children and adolescents with CP [3]. Individuals with CP demonstrate a higher prevalence of fracture [4] and increased risk of fracture with minor stress [5]. Fracture impedes ambulation and affects their quality of life [6]. This necessitates BMD assessment in adults with CP

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