Prevalence of reduced bone mass in children and adults with spastic quadriplegia.
This study was designed to test the hypothesis that non-ambulatory patients with spastic quadriplegia will have reduced bone mass which worsens with increasing age. Forty-eight patients (age 5 to 48 years, median age 15 years; 19 females and 29 males) were studied. Anticonvulsants were used in 29 patients (60.4%). Lumbar spine bone mineral density (LS-BMD) was markedly reduced compared with age-and sex-matched control individuals with a z score of -2.37 +/- 0.21. Twenty-eight (58%) had z scores of less than -2. A history of documented previous fracture was present in 19 patients (39%). Patients with a history of fracture had significantly lower (p = 0.05) LS-BMD z scores (-2.81 +/- 0.29) compared with those without a history of fracture (-2.11 +/- 0.26). Mean serum 25-OH vitamin D was 29.6 +/- 1.9ng/mL (normal 9 to 37.6ng/mL) with three patients having serum 25-OH vitamin D levels less than 15ng/mL. These findings indicate that BMD is markedly reduced in non-ambulatory children and adults with neuromuscular disease. Reductions in bone mass put them at greater risk for non-traumatic fractures.
King
Wilson
W
Division of Pediatric Gastroenterology, Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
Levin
Ronald
R
Schmidt
Rosemary
R
Oestreich
Alan
A
Heubi
James E
JE
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006776:Hospitals, Pediatric; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D009820:Ohio / Q000453:epidemiology; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011782:Quadriplegia / Q000150:complications*; D012307:Risk Factors
D000927:Anticonvulsants