Department of Pediatric Rehabilitation, Medical University of Bialystok, Poland.
Adv Med Sci. 2009;54(2):247-52. doi: 10.2478/v10039-009-0039-y.
Our objective was to assess bone and muscular mass in children with meningomyelocele (MMC), and to analyze risk factors for osteoporosis and fractures based on densitometric examination.
The study group included 30 patients (15 girls and 15 boys) with MMC, aged 6-17 years, treated in the Department of Pediatric Rehabilitation, University Hospital. Physiotherapeutic assessment and laboratory tests (serum parathormone, alkaline phosphatase levels, calcium, and phosphate levels, and urine calcium levels) were performed. Densitometry was measured by dual energy X-ray absorptiometry using a Lunar DPX-L apparatus. Lean mass (fat-free tissue content) and fat mass (% fat content) was evaluated.
Femur fractures were the most common 12/30 (40%); 5/30 (17%) of the children with MMC had multiple fractures. The incidence of fractures correlated significantly with BMI and body fat content (p = 0.03) Children with MMC and fractures had a tendency toward higher BMI, despite the same absolute value of body mass, compared to those without fractures. Body fat levels were higher in MMC patients with fractures than in those without fractures (BMI R = 0.393, p = 0.03). Children with MMC and fractures had significantly higher 24 h calcuria values, despite normal renal function indices (p = 0.03).
Low-energetic fractures in MMC children may result from metabolic disturbances that are a consequence of excessive renal calcium loss or excessive fatty tissue content.
我们的目的是评估脑脊膜膨出（MMC）患儿的骨量和肌肉量，并根据骨密度检查分析骨质疏松症和骨折的危险因素。
研究组包括 30 名（15 名女孩和 15 名男孩）年龄在 6-17 岁的 MMC 患儿，他们在大学医院儿科康复科接受治疗。进行了物理治疗评估和实验室检查（血清甲状旁腺激素、碱性磷酸酶水平、钙和磷水平以及尿钙水平）。使用 Lunar DPX-L 仪器进行双能 X 射线吸收法进行骨密度测量。评估瘦体重（无脂肪组织含量）和体脂肪量（%体脂肪含量）。
股骨骨折最为常见（12/30，40%）；12 名（17%）患有 MMC 的儿童有多处骨折。骨折的发生率与 BMI 和体脂肪含量显著相关（p = 0.03）。与无骨折的儿童相比，患有 MMC 和骨折的儿童的 BMI 较高，尽管体重的绝对值相同。与无骨折的患儿相比，患有 MMC 且有骨折的患儿的体脂肪水平更高（BMI R = 0.393，p = 0.03）。尽管肾功能指数正常，但患有 MMC 和骨折的儿童的 24 小时尿钙值明显更高（p = 0.03）。
MMC 患儿的低能量骨折可能是由于代谢紊乱引起的，这是由于过度的肾钙丢失或过多的脂肪组织含量所致。
