title: Bone mineral density in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy.
abstract: OBJECTIVE
  The present study aimed to assess bone mineral density (BMD) in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy.
  
  
  METHODS
  One hundred thirteen patients (63 male and 50 female) were recruited for evaluation. Patients were divided in three groups: 40 patients (group 1) were affected by cerebral palsy and mental retardation; 47 (group 2) by cerebral palsy, mental retardation, and epilepsy; and 26 (group 3) by epilepsy. The control group consisted of 63 healthy children and adolescents. Patients underwent a dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine (L1-L4), and z-score was calculated for each patient; t-score was considered for patients 18 years of age and older.
  
  
  RESULTS
  Abnormal BMD by DEXA was found in 17 patients (42.5%) in group 1, in 33 (70.2%) in group 2, and in 3 (11.5%) in group 3. In groups 1 and 2, tetraparesis and severe/profound mental retardation were related to a significantly abnormal BMD (p = 0.003). The multivariate analysis of independent factors on BMD (z-score) revealed a significant correlation between BMD (z-score) and age (p = 0.04), body mass index (BMI; p = 0.002), severe/profound mental retardation (p = 0.03), and epilepsy (p = 0.05).
  
  
  CONCLUSIONS
  A significantly lower BMD z-score value was found in patients with cerebral palsy, mental retardation, and epilepsy compared with those without epilepsy. The epileptic disorder appears to be an aggravating factor on bone health when comorbid with cerebral palsy and mental retardation.
authors.affiliation: Clinic of Child Neuropsychiatry, University of Salerno, Salerno, Italy. gcoppola@unisa.it
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.forename: Delia
authors.initials: D
authors.lastname: Fortunato
authors.forename: Ciro
authors.initials: C
authors.lastname: Mainolfi
authors.forename: Francesco
authors.initials: F
authors.lastname: Porcaro
authors.forename: Davide
authors.initials: D
authors.lastname: Roccaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Signoriello
authors.forename: Francesca Felicia
authors.initials: FF
authors.lastname: Operto
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D018672:Community Health Planning; D004827:Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D012720:Severity of Illness Index