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Issue 134 Winter 2019

Endocrinologist > Winter 2019 > Hot topics


Bone density in adolescents with cerebral palsy

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Cerebral palsy is the most common motor disorder amongst children. Many children and young adults with cerebral palsy have reduced mobility, nutritional deficiencies, low sex hormones and take anti-convulsant medication, all of which lead towards poor bone health.

Trinh et al. assessed changes in bone mineral density (BMD) in a retrospective longitudinal study over a 12-year period in 45 young people, 16 of whom had five dual‐energy X‐ray absorptiometry scans. Bone density was low in childhood, with all first-measured BMD Z-scores being less than –2.0. There was an increase in BMD though puberty (mean 4–8%) and bone density was maintained in early adulthood, suggesting a deficit in bone accrual rather than loss of BMD. 25% of patients received bisphosphonate, with no effect, and there was inconsistent use of sex steroids. The authors suggest improving muscle strength, nutrition and mobility is important to optimise bone health, although they also comment that the cohort was not large enough to demonstrate that increases in weight-bearing exercise improved BMD.

Attention to bone health in childhood is important for a population at risk of a low BMD. More work is needed to understand how BMD can be improved further.

Read the full article in Clinical Endocrinology 91 517–524




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