Aug 2026· Düzce Tıp Fakültesi Dergisi· Vol 28, pp. 166-173· 0 citations· 30 references
TL;DR
Metabolic factors, vitamin D levels, and functional limitations influence bone health and the development of secondary osteoporosis in children with CP and a significant negative correlation was found between GMFCS level and BMD.
Abstract
Aim: Cerebral palsy (CP) entails lifelong impairments in movement and posture resulting from non-progressive brain damage. As overall life expectancy increases due to advancements in neonatal conditions, the significance of long-term musculoskeletal health concerns in individuals with CP has grown correspondingly. This study aims to assess bone mineral density (BMD) in pediatric and adolescent populations with CP and investigate clinical, functional, and biochemical factors associated with osteoporosis.Material and Methods: The study included 71 children and adolescents diagnosed with CP. Demographic data, anthropometric measurements, pubertal status, gross motor function classification system (GMFCS) level, treatment details, and fracture history were obtained from hospital records. Serum biochemical parameters and vitamin D levels, vertebral fractures, and lumbar spine BMD measured by dual-energy X-ray absorptiometry were evaluated. Osteoporosis classification was determined using Z-scores.Results: A significant negative correlation was found between GMFCS level and BMD. The osteoporosis group had lower albumin levels, while alkaline phosphatase (ALP) values varied between groups. Patients on anticonvulsants showed reduced calcium and corrected calcium levels, but there was no statistically significant difference in BMD. The rate of osteoporosis was similar across subgroups based on vitamin D status. Additionally, no notable differences were observed between osteoporosis groups in body mass index (BMI) or BMI-standard deviation scores.Conclusion: Metabolic factors, vitamin D levels, and functional limitations influence bone health and the development of secondary osteoporosis in children with CP. GMFCS levels are also a key determinant of bone health. A proactive, multidisciplinary evaluation of bone health is essential for preventing fractures and improving mobility.
Evaluation of skeletal health in children with OI should not rely solely on BMD measurements; vertebral fractures, biochemical markers, growth, and environmental factors should also be considered.
Banu Turhan, N. Yaşar· Turkish Journal of Pediatric...· 0 citations
Evaluation of skeletal health in children with OI should not rely solely on BMD measurements; vertebral fractures, biochemical markers, growth, and environmental factors should also be considered.
Abstract Background Bone and brain interact bidirectionally through the brain–bone axis. However, the relationship between bone mineral density (BMD) and cognitive impairment in Parkinson’s disease (PD) remains unclear. Methods We screened and enrolled 120 PD patients, measuring BMD at the bilateral neck of femur, total hip, one-third distal radius and lumbar spine while assessing various clinical symptoms. Latent class analysis (LCA) was employed for BMD classification, followed by statistical analyses to assess their associations with cognitive impairment. Results Patients with cognitive impairment exhibited generally reduced BMD in the measured skeletal locations compared to those without cognitive impairment, while serum biochemical markers did not show this trend. LCA by utilizing multiple regional BMD measurements classified patients into two distinct clusters: axial osteopenia and generalized osteoporosis. Cognitive impairment was more pronounced in the generalized osteoporosis cluster. Further analysis showed that PD patients in the generalized osteoporosis cluster had an increased risk of cognitive impairment (adjusted odds ratio: 9.02, 95% confidence interval: 2.68–35.40). After stratification, this association was more prominent in older or male patients, in those whose non-dominant hand side exhibited more severe motor symptoms, and in patients with either a longer disease duration or the non-tremor dominant subtype. Conclusions This study demonstrates for the first time that generalized osteoporosis, rather than axial osteopenia, is associated with cognitive impairment in PD. Interventions aimed at mitigating generalized BMD decline could be a potential therapeutic approach to improve cognitive function in PD patients.
INTRODUCTION
Osteoporotic vertebral fractures (OVFs) are a major cause of morbidity in older adults, leading to pain, disability, and decreased quality of life. Although osteoporosis is traditionally associated with women, men also experience substantial morbidity and mortality after fractures. However, the mechanisms underlying sex differences in OVF remain unclear. This study aimed to investigate sex differences in comorbidities, bone mineral density (BMD), nutritional status, and MRI findings in patients with OVF.
METHODS
We retrospectively analyzed 492 patients (126 men and 366 women) hospitalized for OVF between 2015 and 2021. Clinical data, including comorbidities, BMD, Prognostic Nutritional Index (PNI), and MRI signal patterns, were collected. MRI patterns were classified into low- and high-risk groups for delayed bone union. Multivariate logistic regression analysis was performed to identify independent factors associated with high-risk MRI patterns.
RESULTS
Men had a significantly higher prevalence of cardiac, renal, and brain disorders, as well as malignancy, compared with women. Men also had significantly higher BMD but lower PNI values. High-risk MRI patterns were more frequent in men in univariate analysis (41.3% vs. 30.0%, p = 0.039). However, multivariate logistic regression analysis revealed that PNI was independently associated with high-risk MRI patterns (OR 0.943 per point increase, 95% CI 0.902-0.986, p = 0.0098), whereas sex was not.
CONCLUSIONS
Poor nutritional status was independently associated with high-risk MRI patterns in patients with OVF. The observed sex differences in acute radiological risk may be partially explained or mediated by differences in baseline nutritional status rather than biological sex itself.
Tatsuya Yasuda, Junichiro Sarukawa, Kaoru Yamazaki et al.· Journal of Orthopaedic Scien...· 0 citations
The study indicates that lower BHI SDS values are associated with increased fracture risk in children with classical OI and indicates that BHI may represent a clinically useful complementary tool for fracture risk stratification in young children with OI, particularly where DXA is unavailable or technically limited, including infancy.
Ruggero Lanzafame, Alistair D. Calder, B. Crowe et al.· Journal of Clinical Endocrin...· 0 citations
The findings suggest that the clinical role of TBS in the assessment of pediatric bone health remains to be established, and that larger prospective studies are needed to clarify the clinical value of TBS for fracture risk assessment in pediatric autoimmune gastrointestinal diseases.
Anna Łupińska, Sara Aszkiełowicz, Arkadiusz Zygmunt et al.· Nutrients· 0 citations
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