title: Greater Adipose Tissue Distribution and Diminished Spinal Musculoskeletal Density in Adults With Cerebral Palsy.
abstract: OBJECTIVE
  To examine differences in adipose tissue distribution, lumbar vertebral bone mineral density (BMD), and muscle attenuation in adults with and without cerebral palsy (CP), and to determine the associations between morphologic characteristics.
  
  
  METHODS
  Cross-sectional, retrospective analyses of archived computed tomography scans.
  
  
  METHODS
  Clinical treatment and rehabilitation center.
  
  
  METHODS
  Adults (N=352) with CP (age, 38.8±14.4y; body mass, 61.3±17.1kg; Gross Motor Function Classification System levels, I-V) and a matched cohort of neurotypical adults. Of the 41 adults with CP included in the study, 10 were not matchable because of low body masses.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Computed tomography scans were assessed for visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas, psoas major area and attenuation in Hounsfield units (Hu), and cortical and trabecular BMDs.
  
  
  RESULTS
  Adults with CP had lower cortical (β=-63.41 Hu, P<.001) and trabecular (β=-42.24 Hu, P<.001) BMDs and psoas major areas (β=-374.51mm(2), P<.001) and attenuation (β=-9.21 Hu, P<.001) after controlling for age, sex, and body mass. Adults with CP had greater VAT (β=3914.81mm(2), P<.001) and SAT (β=4615.68mm(2), P<.001). Muscle attenuation was significantly correlated with trabecular (r=.51, P=.002) and cortical (r=.46, P<.01) BMD, whereas VAT was negatively associated with cortical BMD (β=-.037 Hu/cm(2), r(2)=.13, P=.03).
  
  
  CONCLUSIONS
  Adults with CP had lower BMDs, smaller psoas major area, greater intermuscular adipose tissue, and greater trunk adiposity than neurotypical adults. VAT and cortical BMD were inversely associated.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: mdpeterz@med.umich.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Peterson
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI; Morphomic Analysis Group, University of Michigan, Ann Arbor, MI.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Haapala
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI; Morphomic Analysis Group, University of Michigan, Ann Arbor, MI.
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Hurvitz
mesh_terms: D000328:Adult; D050218:Body Fat Distribution; D015519:Bone Density; D002547:Cerebral Palsy / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D055948:Sarcopenia / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Adiposity; Bone density; Cerebral palsy; Intra-abdominal fat; Rehabilitation; Sarcopenia