Bone metabolism biomarkers in walking children with cerebral palsy

Kenis, Vladimir; Маркович, Кенис Владимир; Bogdanova, S.; Леонидовна, Богданова Светлана; Prokopenko, Tatyana N.; Николаевна, Прокопенко Татьяна; Sapogovskiy, Andrey V.; Викторович, Сапоговский Андрей; Kiseleva, T. I.; Ильинична, Киселева Татьяна

doi:10.17816/ptors7479-86

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…10 Studies have investigated the utility of biomarkers in patients with CP but were centered around diagnostic prediction, pathophysiology, and comorbidities. [11][12][13] In addition, other studies have investigated the association between hip pain and degenerative joint changes in individuals with CP but primarily involved patients who were either nonambulatory or had sustained a hip dislocation. 14 To our knowledge, no study has used biomarkers as a correlate of ambulatory status, functional capacity, and pain in individuals with CP.…”

Section: What Is Knownmentioning

confidence: 99%

Comparative Study of the Pain, Function and Biomarkers of Joint Disease in the Transition to Adulthood in Individuals With and Without Cerebral Palsy

Hanaoka

Gaebler‐Spira

Pichika

et al. 2023

Am J Phys Med Rehabil

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Background Biomarkers have potential to identify early signs of joint disease. This study compared joint pain and function in adolescents and young adults with CP compared to individuals without. Methods Cross-sectional study compared individuals with CP(n = 20), aged 13-30 with Gross Motor Function Classification System (GMFCS) I-III and age-matched individuals without CP(n = 20). Knee and hip joint pain measured using Numeric Pain Rating Scale (NPRS) and Knee injury and Osteoarthritis Outcome Score (KOOS) and Hip dysfunction and Osteoarthritis Outcome Score (HOOS) surveys. Objective strength and function were also measured. Biomarkers for tissue turnover (serum COMP, urinary CTX-II) and cartilage degradation (serum MMP-1, MMP-3) were measured in blood and urinary samples. Findings Individuals with CP had increased knee and hip joint pain, reduced leg strength, reduced walking and standing speeds, and ability to carry out activities of daily living(p < 0.005) compared to controls. They also had higher serum MMP-1(p < 0.001) and urinary CTX-II levels(p < 0.05). Individuals with CP who were GMFCS I and II demonstrated reduced hip joint pain(p = 0.02) and higher MMP-1 levels (p = 0.02) compared to GMFCS III. Interpretation Individuals with CP with less severe mobility deficits had higher MMP-1 levels likely due to more prolonged exposure to abnormal joint loading forces but experienced less joint pain.

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Section: What Is Knownmentioning

confidence: 99%

Comparative Study of the Pain, Function and Biomarkers of Joint Disease in the Transition to Adulthood in Individuals With and Without Cerebral Palsy

Hanaoka

Gaebler‐Spira

Pichika

et al. 2023

Am J Phys Med Rehabil

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“…Наиболее вероятным фактором, приводящим к нарушению минерализации костной ткани, у детей с нейроортопедическими заболеваниями, к которым относится и ДЦП, считают снижение общей двигательной активности, или так называемую остеопению от бездействия, характеризующуюся снижением костного анаболизма [14]. Согласно теории механостата, прочность костей регулируется мышечной силой.…”

Section:  введениеunclassified

Bone Mineral Density in Children with Cerebral Palsy

Галашевская¹,

Почкайло²

2023

Педиатрия. Восточная Европа

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Цель. Оценить минеральную плотность костной ткани (МПК) по данным двухэнергетической рентгеновской абсорбциометрии и представить частоту нарушений костной плотности у детей с детским церебральным параличом (ДЦП). Материалы и методы. В исследование включено 106 детей в возрасте 5–18 лет (медиана – 10,4 (8,1; 13,2) года) с ДЦП, находившихся на обследовании в республиканском центре детского остеопороза. Оценка МПК проводилась методом двухэнергетической рентгеновской абсорбциометрии по программам исследования всего тела (без учета костной ткани черепа, TBLH) и поясничного отдела позвоночника (L1–L4). Согласно рекомендациям Международного общества клинической денситометрии (ISCD), низкая МПК определялась при значениях Z-критерия ≤–2,0 SD. Результаты. В когорте обследованных пациентов с ДЦП медиана МПК L1–L4 составила 0,476 (0,406; 0,587) г/см2, МПК TBLH – 0,581 (0,521; 0,663) г/см2; Z-критерий МПК L1–L4 – –0,7 (–3,0; –0,4) SD, Z-критерий МПК TBLH – 0,6 (–0,7; 1,8) SD. Установлено, что частота выявления низкой МПК не была ассоциирована с полом и возрастом ребенка и составила в общей когорте обследованных детей с ДЦП 46,2%, достигая среди пациентов, принимавших антиконвульсанты, 61,4%, у детей с IV–V уровнями по GMFCS – 71,4%, с переломами в анамнезе – 78,6%, с недостаточностью питания – 82,9%, с низкорослостью – 86,8%. У каждого пятого ребенка с низкой МПК верифицирован остеопороз (20,4%). Заключение. Выявлена высокая частота низкой МПК среди детей с ДЦП. Снижение МПК у детей с ДЦП было ассоциировано с приемом антиконвульсантов, снижением мобильности (IV–V уровни по GMFCS), наличием переломов в анамнезе, недостаточностью питания и низкорослостью. Purpose. To assess the bone mineral density (BMD) according to Dual-energy X-ray absorptiometry and to present the frequency of bone density disorders in children with cerebral palsy (CP). Materials and methods. The study included 106 children aged 5–18 years (median age – 10.4 (8.1; 13.2) years) with CP who were examined at the Republican Center for Pediatric Osteoporosis. Total body less head (TBLH) BMD and lumbar spine (L1–L4) BMD were measured by means of Dual-energy X-ray absorptiometry. According to the International Society for Clinical Densitometry (ISCD) guidelines, low BMD was defined as Z-score ≤–2.0 SD. Results. The median L1–L4 BMD in the cohort of examined patients with CP was 0.476 (0.406; 0.587) g/cm2, TBLH BMD was 0.581 (0.521; 0.663) g/cm2. The median BMD Z-score (L1–L4) was –0.7 (–3.0; –0.4) SD, BMD Z-score (TBLH) was 0.6 (–0.7; 1.8) SD. It was found that the frequency of low BMD was not associated with the sex and age of the child and amounted to 46.2% in the total cohort of the examined children with CP, reaching 61.4% among patients taking antiepileptic drugs, in children with IV–V levels of GMFCS – 71.4%, with a history of fractures – 78.6%, with undernutrition – 82.9%, and with short stature – 86.8%. Osteoporosis was diagnosed in every fifth child with low BMD (20.4%). Conclusion. A high frequency of low BMD was revealed among children with CP. Decreased BMD in children with CP was associated with taking antiepileptic drugs, decreased gross motor function (IV-V levels according to GMFCS), and a history of fractures, malnutrition, and short stature.

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Changes in bone metabolism during cerebral palsy

Maslova

Звонкова

Боровик

et al. 2022

RPJ

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Introduction. Patients with cerebral palsy (CP) are especially vulnerable to the development of osteopenia. Skeletal deformities caused by immobility (prolonged bed rest, limited exercise, immobilization), antiepileptic drugs, hormonal and genetic factors can lead to significant bone loss. Diagnosis of osteoporosis includes densitometry and the study of biochemical markers to assess the state of bone mineralization at the time of the examination. However, densitometry in patients with cerebral palsy may present certain difficulties. Purpose is to determine changes in the content of bone tissue metabolism markers in CP patients depending on the severity of movement disorders. Materials and methods. We examined 32 CP patients aged 2 to 15 years for 3 months who were in rehabilitation in 2019-2021. The patients were divided into 2 groups: 18 children in the main group with motor dysfunctions of level IV-V and 14 children in the comparisons group - with disorders of I-III levels. All children underwent an analysis of anthropometric parameters using the program “WHO AnthroPlus (2009)”, determination of the blood levels of biochemical markers of bone tissue metabolism: calcium, phosphorus, alkaline phosphatase, osteocalcin, vitamin D, parathyroid hormone, bone resorption marker β-CrossLaps. Results. The indices of alkaline phosphatase, calcium and phosphorus in the majority of CP patients (88%) were within the reference values. The average concentrations of these compounds did not differ significantly in CP patients in the main group and the comparison group, including between children who received and did not receive antiepileptic drugs. There were no significant differences in 25(OH)D concentrations in patients of these groups. CP patients from the main group were found to be supplemented with vitamin D less frequently than children from the comparison group. Indicators of bone tissue resorption (β-CrossLaps) in patients with cerebral palsy increased significantly more than in patients of the comparison group, which indicates a pronounced loss of bone mass in severe impairment of motor functions. More than half of CP patients have high values of the bone resorption marker β-CrossLaps, which, together with an increase in the level of osteocalcin, indicates active osteoreparation, which is higher in children with severe motor disorders. At the same time, a close correlation (r = 0.596; p < 0.05) between the levels of osteocalcin and β-CrossLaps in patients may indicate activation of bone tissue repair in response to pronounced resorption. However, it should be noted that the determination of biomarkers of bone tissue metabolism in children with cerebral palsy is not indicative in the detection of osteopenia and osteoporosis due to the characteristics of these patients: reduced motor activity, growth retardation and psychophysical development.

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Bone metabolism biomarkers in walking children with cerebral palsy

Cited by 3 publications

References 11 publications

Comparative Study of the Pain, Function and Biomarkers of Joint Disease in the Transition to Adulthood in Individuals With and Without Cerebral Palsy

Comparative Study of the Pain, Function and Biomarkers of Joint Disease in the Transition to Adulthood in Individuals With and Without Cerebral Palsy

Bone Mineral Density in Children with Cerebral Palsy

Changes in bone metabolism during cerebral palsy

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