Aljishi Aqeelah Abdulelah, Al-Omari Mohammed A, Al Safar Ayat H, AlHazzaa Shahad A, Ibrahim Alaa I
Alahsa Health Cluster, Ministry of Health, Hofuf 36421, Saudi Arabia.
Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahad Hospital of the University, Al-Khobar 31952, Saudi Arabia.
Children (Basel). 2025 Jul 7;12(7):894. doi: 10.3390/children12070894.
Cerebral palsy (CP) is the most common cause of neurological disability in children and is frequently associated with low bone mineral density (BMD) and increased risk of fractures. This study aimed to assess BMD in children with CP, compare it with normative standards, and explore potential associations with anthropometric parameters and the clinical characteristics of children with CP. Thirty-six children with CP aging 6-15 years from both sexes with varying levels of Gross Motor Functional Classification System (GMFCS) and spasticity were evaluated. Areal BMD and Z-scores (total and subtotal) were measured using dual-energy X-ray absorptiometry (DXA). Regression analysis identified predictors of BMD. Children with GMFCS levels III-V had significantly lower total and subtotal Z-scores compared to those with levels I-II ( = 0.001 and = 0.02, respectively). Total Z-score was significantly predicted by weight (β = 1.02, = 0.002), height (β = -0.72, = 0.02), and sedentary time (β = -0.47, = 0.005). "No walking" was the only significant predictor for subtotal Z-score (β = -0.50, = 0.004). Children with moderate to severe CP exhibited significantly lower BMD, particularly those with limited ambulation and higher spasticity levels. These findings underscore the importance of early screening and targeted interventions to optimize bone health in this population.
脑性瘫痪（CP）是儿童神经功能障碍最常见的病因，常伴有低骨矿物质密度（BMD）及骨折风险增加。本研究旨在评估CP患儿的BMD，将其与标准规范进行比较，并探讨其与人体测量参数及CP患儿临床特征之间的潜在关联。对36名年龄在6至15岁、具有不同程度的粗大运动功能分级系统（GMFCS）和痉挛程度的CP患儿（男女均有）进行了评估。使用双能X线吸收法（DXA）测量面积BMD和Z评分（总分和分项分数）。回归分析确定了BMD的预测因素。与GMFCS I-II级的患儿相比，GMFCS III-V级的患儿总分和分项Z评分显著更低（分别为P = 0.001和P = 0.02）。体重（β = 1.02，P = 0.002）、身高（β = -0.72，P = 0.02）和久坐时间（β = -0.47，P = 0.005）可显著预测总分Z评分。“无法行走”是分项Z评分的唯一显著预测因素（β = -0.50，P = 0.004）。中重度CP患儿的BMD显著更低，尤其是那些行走能力受限且痉挛程度较高的患儿。这些发现强调了早期筛查和针对性干预对于优化该人群骨骼健康的重要性。
