title: Bone mineral density and insulin-like growth factor-1 in children with spastic cerebral palsy.
abstract: BACKGROUND
  Children with cerebral palsy (CP) have significant decrease linear growth rate and low bone mineral density (BMD).
  
  
  OBJECTIVE
  This study is to evaluate BMD in children with CP and its relation to the levels of insulin-like growth factor-1 (IGF-1).
  
  
  METHODS
  This cross-sectional study was carried out on 58 children suffering from spastic CP with the age range 4-12 years compared to 19 controls. All assessed by dual energy x-ray absorptiometry (DXA) to measure BMD, serum level of IGF-1, and serum vitamin D. The patients were classified according to their GMFCS.
  
  
  RESULTS
  Fractures were reported in seven (12.1%) of cases. Our study demonstrated that, IGF-1 level and BMD decrease in correlation with the severity of CP. IGF-1correlates positively with serum vitamin D, BMI, and BMD. CP children with severe GMFCS level or who use anticonvulsive drugs are at a high risk for low BMD and low levels of IGF-1.
  
  
  CONCLUSIONS
  Both BMD and IGF-1 were significantly in low children with spastic CP; IGF-1 negatively correlates with the severity of osteopenia in children with spastic. Children with CP who are not independently ambulant or with severe GMFCS level or who use anticonvulsive drugs are at a high risk for developing low BMD.
authors.affiliation: Department of Childhood Medical Studies, Institute of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Nazif
authors.affiliation: Department of Pediatrics, Pediatric Neurology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: R
authors.initials: R
authors.lastname: Shatla
authors.affiliation: Deparment of Pediatrics, Pediatric Neurology Unit, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt. shewaka1971@yahoo.com.
authors.forename: R
authors.initials: R
authors.lastname: Elsayed
authors.affiliation: Department of Physical Medicine, Rheumatology and Rehabilitation Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: E
authors.initials: E
authors.lastname: Tawfik
authors.affiliation: Department of Radio Diagnoses, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: N
authors.initials: N
authors.lastname: Osman
authors.affiliation: Department of Molecular Biology, National Center for Radiation Research and Technology, Cairo, Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Korra
authors.affiliation: Department of Childhood Medical Studies, Institute of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Ibrahim
mesh_terms: D015502:Absorptiometry, Photon; D000927:Anticonvulsants; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000097:blood; D002547:Cerebral Palsy / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood
chemical_list: D000927:Anticonvulsants; D014807:Vitamin D; D007334:Insulin-Like Growth Factor I
keywords: Bone mineral density; IGF-1; Spastic CP; Vitamin D