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Correlations between bone mineral density(BMD) and disease severity in children with cerebral palsy |
WANG Huan1, YAO Dandan1, YAN Hua2, ZHAOYuanchuang3, LIUGang1, ZHU Zhenglin4 |
1. Department of Rehabilitation,2.Department of Pediatric Orthopedics,the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630 China; 3. Department of Traditional Chinese Medicine Rehabilitation,4.Department of Medical Service, Guangdong Provincial Corps Hospital of Chinese People’s Armed Police Force, Guangzhou 510507 China |
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Abstract Objective To investigate the correlations between bone mineral density(BMD) and disease severity in children with cerebral palsy(CP).Methods A total of 142 children with cerebral palsy who were aged 1 to 4 and followed up in our hospital were enrolled. According to their physical development, 82 cases were assigned to the group of CP with developmental delay and 60 cases to the group of normal CP. According to the gross motor function classification system (GMFCS), 40 patients were defined as mild motor impairment (GMFCS grade 1 to 2), 72 patients as moderate disorder (GMFCS grade 3 to 4), and 30 patients as severe disorder (GMFCS grade 5), while another 57 children with normal development were selected as control group. The difference in BMD, serum calcium levels, and insulin-like growth factor-1 (IGF-1) levels between these groups was studied. The correlations between BMD and GMFCS classification were analyzed.Results The levels of BMD in the vertebral column and proximal femur, serum calcium and IGF-1 in CP patients were significantly lower than those in the healthy control group[Lumbar:(0.46±0.11) g/cm2 vs (0.56±0.13) g/cm2,P<0.001; proximal femur (0.43±0.06) g/cm2 vs (0.53±0.12) g/cm2,P<0.001]. There was a significantly negative correlation between BMD and GMFCS grading in the vertebral column and proximal femur(Lumbar vertebra:r=-0.363,P<0.001; Proximal femur:r=-0.491,P<0.001). Serum calcium and IGF-1 levels were also decreased in CP patients compared with control. The higher GMFCS grading, the lower the levels of serum calcium and IGF-1.Conclusion There is a negative correlation between bone mineral density and disease severity in children with CP, indicating abnormal bone metabolism in children with cerebral palsy.
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Received: 05 November 2018
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