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- Title
Musculoskeletal and Endocrine Health in Adults With Cerebral Palsy: New Opportunities for Intervention.
- Authors
Trinh, A; Wong, P; Fahey, M C; Brown, J; Churchyard, A; Strauss, B J; Ebeling, P R; Fuller, P J; Milat, F
- Abstract
<bold>Context: </bold>Cerebral palsy (CP) increases fracture risk through diminished ambulation, nutritional deficiencies, and anticonvulsant medication use. Studies examining bone mineral density (BMD) in adults with CP are limited.<bold>Objective: </bold>To examine the relationship between body composition, BMD, and fractures in adults with CP. The effect of functional, nutritional, and endocrine factors on BMD and body composition is also explored.<bold>Design: </bold>Retrospective cross-sectional study.<bold>Setting and Participants: </bold>Forty-five adults with CP (mean age, 28.3 ± 11.0 years) who had dual-energy x-ray absorptiometry imaging at a single tertiary hospital between 2005 and 2015.<bold>Results: </bold>Seventeen (38%) had a past history of fragility fracture; 43% had a Z-score of ≤ -2.0 at the lumbar spine (LS) and 41% at the femoral neck (FN). In nonambulatory patients, every one unit decrease in FN Z-score increased the risk of fracture 3.2-fold (95% confidence interval, 1.07-9.70; P = .044). Stepwise linear regression revealed that the Gross Motor Function Classification System was the best predictor of LS Z-score (R(2) = 0.550; β = -0.582; P = .002) and FN Z-score (R(2) = 0.428; β = -0.494; P = .004); 35.7% of the variance in BMD was accounted for by lean tissue mass. Hypogonadism, present in 20% of patients, was associated with reduced lean tissue mass and reduced LS BMD. Lean tissue mass positively correlated with BMD in eugonadal patients, but not in hypogonadal patients.<bold>Conclusions: </bold>Low BMD and fractures are common in adults with CP. This is the first study to document hypogonadism in adults with CP with detrimental changes in body composition and BMD.
- Subjects
CEREBRAL palsy treatment; BODY composition; CEREBRAL palsy; BONE fractures; HYPOGONADISM; MUSCULOSKELETAL system; BONE density; ENDOCRINE system; CROSS-sectional method; RETROSPECTIVE studies; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2016, Vol 101, Issue 3, p1190
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2015-3888