title: Bone density in premenopausal women and men under 50 years of age with cerebral palsy.
abstract: OBJECTIVE
  To determine bone mineral density (BMD) z scores in adults with cerebral palsy (CP), an understudied population.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Medical facility.
  
  
  METHODS
  Adults (N=48; mean age, 34.3±5.8y; range, 25-46y) with CP.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  BMD z scores at the lumbar spine and hip using dual-energy x-ray absorptiometry, Gross Motor Function Classification System (GMFCS), body mass index (BMI), and ambulatory status.
  
  
  RESULTS
  Mean BMD z scores were -1.40 for the lumbar spine, -1.36 for the total hip, and -1.02 for the femoral neck. The z scores were significantly lower for the nonambulatory group at all 3 sites (P<.05). Significant differences were found among GMFCS levels for the lumbar spine and total hip z scores (P<.05). For the lumbar spine, the mean z scores for level V (the lowest mobility level) were significantly lower than the mean for levels I/II (P=.001), III (P=.002), and IV (P=.013). For the total hip, the mean z scores for level V were significantly lower than the mean for levels I/II (P=.045). A significant positive relationship between the z scores and age was found for the lumbar spine (Spearman ρ=.40, P=.005). Significant positive relationships between BMI and z scores were found for all sites (P<.05).
  
  
  CONCLUSIONS
  This study contributes to the sparse literature about bone health in adults with CP. In contrast with pediatric data, z scores did not decrease as a function of age in this adult cohort. This information is important for clinicians considering treatment options for this population.
authors.affiliation: UCLA Center for Cerebral Palsy, Orthopaedic Institute for Children, University of California, Los Angeles, CA; Department of Orthopaedic Surgery, University of California, Los Angeles, CA; Tarjan Center at UCLA, University of California, Los Angeles, CA. Electronic address: efowler@mednet.ucla.edu.
authors.forename: Eileen G
authors.initials: EG
authors.lastname: Fowler
authors.affiliation: Department of Rehabilitation Services, University of California Irvine Health, Orange, CA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Rao
authors.affiliation: Department of Orthopaedic Surgery, University of California, Los Angeles, CA.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Nattiv
authors.affiliation: UCLA Center for Cerebral Palsy, Orthopaedic Institute for Children, University of California, Los Angeles, CA; Department of Orthopaedic Surgery, University of California, Los Angeles, CA.
authors.forename: Kent
authors.initials: K
authors.lastname: Heberer
authors.affiliation: UCLA Center for Cerebral Palsy, Orthopaedic Institute for Children, University of California, Los Angeles, CA; Department of Orthopaedic Surgery, University of California, Los Angeles, CA.
authors.forename: William L
authors.initials: WL
authors.lastname: Oppenheim
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D002547:Cerebral Palsy / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D017697:Premenopause / Q000502:physiology*; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Adult; Bone density; Cerebral palsy; Rehabilitation