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Neuropediatrics 2015; 46(06): 385-391
DOI: 10.1055/s-0035-1563695
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Differential Analysis of Bone Density in Children and Adolescents with Neuromuscular Disorders and Cerebral Palsy

Shadi Razmdjou
1   Department of Neuropediatrics and Muscular Diseases, Center of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
,
Jochen Seufert
2   Department of Endocrinology and Diabetology, University Medical Center, Freiburg, Germany
,
Cornelia Rensing-Zimmermann
1   Department of Neuropediatrics and Muscular Diseases, Center of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
,
Janbernd Kirschner
1   Department of Neuropediatrics and Muscular Diseases, Center of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
,
Rudolf Korinthenberg
1   Department of Neuropediatrics and Muscular Diseases, Center of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
› Author Affiliations
Further Information

Publication History

20 February 2015

28 July 2015

Publication Date:
26 September 2015 (online)

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Abstract

Determinants that affect bone density in disabled children and adolescents with neuromuscular disorders have not been differentially investigated well. We performed dual-energy X-ray absorptiometry of the lumbar spine in three groups (Duchenne muscular dystrophy, n = 16; other neuromuscular diseases, n = 11; and cerebral palsy, n = 18) providing height-age- and sex-adjusted z scores. Mobility was assessed by functional tests. Seven Duchenne patients were taking glucocorticoids; two reported previous treatment. We documented vitamin D blood levels and markers of bone turnover. Many patients presented low bone density for height-age (mean z score =  − 0.86 ± 1.47). Areal bone density increased with age in the cerebral palsy and “other neuromuscular disease” groups, however, the Duchenne group demonstrated a decrease of z scores (r =  − 0.622, p = 0.010). Tanner stage, body mass index, and mobility were independent variables affecting bone density. Vitamin D levels were low, but similar to those reported in healthy children. We conclude that bone mineral density in disabled children is mainly determined by their level of physical maturity, thriving, and mobility.

Keywords

Duchenne muscular dystrophy - cerebral palsy - bone mineral density - ambulatory ability
 

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