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01-12-2018 | Original Article

Bone mineral density and nutritional status in children with quadriplegic cerebral palsy

Authors: Citlalli Alvarez Zaragoza, Edgar Manuel Vasquez Garibay, Andrea A. García Contreras, Alfredo Larrosa Haro, Enrique Romero Velarde, Alejandro Rea Rosas, José Luis Cabrales de Anda, Israel Vega Olea

Published in: Archives of Osteoporosis | Issue 1/2018

Abstract

Summary

This study demonstrated the relationship of low bone mineral density (BMD) with the degree of motor impairment, method of feeding, anthropometric indicators, and malnutrition in children with quadriplegic cerebral palsy (CP). The control of these factors could optimize adequate bone mineralization, avoid the risk of osteoporosis, and would improve the quality of life.

Purpose

The purpose of the study is to explore the relationship between low BMD and nutritional status in children with quadriplegic CP.

Methodology

A cross-sectional analytical study included 59 participants aged 6 to 18 years with quadriplegic CP. Weight and height were obtained with alternative measurements, and weight/age, height/age, and BMI/age indexes were estimated. The BMD measurement obtained from the lumbar spine was expressed in grams per square centimeter and Z score (Z). Unpaired Student’s t tests, chi-square tests, odds ratios, Pearson’s correlations, and linear regressions were performed.

Results

The mean of BMD Z score was lower in adolescents than in school-aged children (p = 0.002). Patients with low BMD were at the most affected levels of the Gross Motor Function Classification System (GMFCS). Participants at level V of the GMFCS were more likely to have low BMD than levels III and IV [odds ratio (OR) = 5.8 (confidence interval [CI] 95% 1.4, 24.8), p = 0.010]. There was a higher probability of low BMD in tube-feeding patients [OR = 8.6 (CI 95% 1.0, 73.4), p = 0.023]. The probability of low BMD was higher in malnourished children with weight/age and BMI indices [OR = 11.4 (1.3, 94), p = 0.009] and [OR = 9.4 (CI 95% 1.1, 79.7), p = 0.017], respectively.

Conclusion

There was a significant relationship between low BMD, degree of motor impairment, method of feeding, and malnutrition. Optimizing these factors could reduce the risk of osteopenia and osteoporosis and attain a significant improvement of quality of life in children with quadriplegic CP.

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Title: Bone mineral density and nutritional status in children with quadriplegic cerebral palsy
Authors: Citlalli Alvarez Zaragoza
Edgar Manuel Vasquez Garibay
Andrea A. García Contreras
Alfredo Larrosa Haro
Enrique Romero Velarde
Alejandro Rea Rosas
José Luis Cabrales de Anda
Israel Vega Olea
Publication date: 01-12-2018
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-018-0434-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Bone mineral density and nutritional status in children with quadriplegic cerebral palsy

Abstract

Summary

Purpose

Methodology

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Purpose

Methodology

Results

Conclusion

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