BONE-MINERAL DENSITY IN CHILDREN AND ADOLESCENTS WHO HAVE SPASTIC CEREBRAL-PALSY
BONE-MINERAL DENSITY IN CHILDREN AND ADOLESCENTS WHO HAVE SPASTIC CEREBRAL-PALSY
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DOI：
10.2106/00004623-199511000-00005
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发表时间：
1995-11-01
影响因子：
5.3
通讯作者：
GREENE, WB
中科院分区：
文献类型：
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作者：
HENDERSON, RC;LIN, PP;GREENE, WB
对139名患有痉挛性脑瘫的儿童（平均年龄9岁，范围3 ~ 15岁）进行骨密度研究，评估包括血清分析和基于饮食史和人体测量的营养评估。采用双能X线骨密度仪测量股骨近端和腰椎的骨密度，并以95名正常儿童和青少年作为对照组，骨矿物质密度变化很大，但股骨近端的平均值比年龄匹配的正常值低近一个标准差（-0.92标准差）和腰椎（-0.80标准差），行走状态是与骨矿物质密度最相关的因素，营养状况，根据热量摄入，皮褶和体重指数进行评估，是第二个最重要的变量，参与模式，固定在石膏中的持续时间，每日钙摄入量低于500毫克是其他不太显著的因素。儿童首次行走的年龄、既往骨折史、抗惊厥药的使用和血清维生素D水平与骨矿物质密度无相关性，校正了与行走状态和营养状态的协方差后，血清钙、磷酸盐、碱性磷酸酶水平，和骨钙素不是低骨密度的可靠指标。
Bone-mineral density was studied in a heterogeneous group of 139 children (mean age, nine years; range, three to fifteen years) who had spastic cerebral palsy, The evaluation included serum analyses and a nutritional assessment based on a dietary history and anthropometric measurements. The bone-mineral density of the proximal parts of the femora and the lumbar spine was measured with dual-energy x-ray absorptiometry and was normalized for age against a series of ninety-five normal children and adolescents who served as controls, Bone-mineral density varied greatly but averaged nearly one standard deviation below the age-matched normal means for both the proximal parts of the femora (-0.92 standard deviation) and the lumbar spine (-0.80 standard deviation), Ambulatory status was the factor that best correlated with bone-mineral density, Nutritional status, assessed on the basis of caloric intake, skinfolds, and body-mass index, was the second most significant variable, The pattern of involvement, durations of immobilization in a cast, and a calcium intake of less than 500 milligrams per day were additional factors of less significance, The age when the child first walked, previous fractures, use of anticonvulsants, and serum vitamin-D levels did not correlate with bone-mineral density after adjustment for covariance with the ambulatory status and the nutritional status, Serum levels of calcium, phosphate, alkaline phosphatase, and osteocalcin were not reliable indicators of low bone-mineral density.