Prevalence of reduced bone mass in children and adults with spastic quadriplegia
Prevalence of reduced bone mass in children and adults with spastic quadriplegia
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DOI：
10.1017/s0012162203000033
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发表时间：
2003-01-01
影响因子：
3.8
通讯作者：
Heubi, JE
中科院分区：
文献类型：
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作者：
King, W;Levin, R;Heubi, JE
这项研究旨在验证这样一种假设，即痉挛四肢瘫痪的非步行患者的骨量会减少，随着年龄的增长，骨量会恶化。48例患者(年龄5-48岁，中位年龄15岁；女性19例，男性29例)被纳入研究。29例(60.4%)应用了抗惊厥药物。与年龄和性别匹配的对照组相比，腰椎骨密度(LS-BMD)显著降低，z分数为-2.37+/-0.21。28人(58%)的z得分低于-2。有记录的既往骨折病史有19例(39%)。有骨折史患者的LS-BMD z评分(-2.81+/-0.29)显著低于无骨折病史患者(-2.11+/-0.26)(P=0.05)。血清25-OH维生素D平均为29.6+/-1.9 ng/m L(正常9~37.6 ng/m L)，其中3例血清25-羟基维生素D<15 ng/m L。这些发现表明，患有神经肌肉疾病的非卧床儿童和成人的骨密度显著降低。骨量的减少使他们患非创伤性骨折的风险更大。
This study was designed to test the hypothesis that non-ambulatory patients with spastic quadriplegia will have reduced bone mass which worsens with increasing age. Forty-eight patients (age 5 to 48 years, median age 15 years; 19 females and 29 males) were studied. Anticonvulsants were used in 29 patients (60.4%). Lumbar spine bone mineral density (LS-BMD) was markedly reduced compared with age-and sex-matched control individuals with a z score of -2.37+/-0.21. Twenty-eight (58%) had z scores of less than -2. A history of documented previous fracture was present in 19 patients (39%). Patients with a history of fracture had significantly lower (p=0.05) LS-BMD z scores (-2.81+/-0.29) compared with those without a history of fracture (-2.11+/-0.26). Mean serum 25-OH vitamin D was 29.6+/-1.9ng/mL (normal 9 to 37.6ng/mL) with three patients having serum 25-OH vitamin D levels less than 15ng/mL. These findings indicate that BMD is markedly reduced in non-ambulatory children and adults with neuromuscular disease. Reductions in bone mass put them at greater risk for non-traumatic fractures.