A comparative analysis of bone mineral density in cerebral palsy and spinal muscular atrophy

IF 3.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports Pub Date : 2025-12-01 Epub Date: 2025-11-28 DOI:10.1016/j.bonr.2025.101891

Brianna G. Bowden , Brett Klamer , Robin Alexander , Mariah Eisner , Garey Noritz

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Abstract

Introduction

Patients with cerebral palsy (CP) and spinal muscular atrophy (SMA) with immobility are at risk for low bone mineral density (BMD) and fragility fractures. This study investigates whether BMD differs between these two groups given their distinct pathological mechanisms.

Methods

Data were collected from non-ambulatory patients diagnosed with CP (GMFCS IV-V) and SMA (type I–II), aged five years and older, who were seen at a metabolic bone clinic between January 2012 and July 2023. Dual-energy X-ray absorptiometry (DXA) assessed BMD at the lumbar spine (LS) and lateral distal femur (LDF), region 3 (R3). Z-scores were calculated and compared between groups using the Wilcoxon rank sum test.

Results

This study included 274 children with CP and 16 with SMA. Unadjusted LS Z-scores were low and comparable in both groups (CP: −2.3, SMA: −2.6; p = 0.7). After adjusting for height, LS Z-scores were in the normal range (CP: −0.9, SMA: −1.6; p = 0.3). However, the SMA group had significantly lower BMD in R3 of the LDF compared to the CP group (CP: −2.9, SMA: −3.9; p = 0.047).

Conclusion

Both groups had normal height adjusted LS BMD and low R3 LDF BMD, with the SMA group significantly lower. We theorize that it may be due to the differences in muscle tonicity on the bone. We recommend including the distal femur bone density in routine bone health assessments and that BMD should be adjusted for height when possible.

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脑瘫与脊髓性肌萎缩骨密度的比较分析

脑性瘫痪（CP）和脊髓性肌萎缩（SMA）伴不动的患者存在低骨密度（BMD）和脆性骨折的风险。本研究探讨了考虑到两组不同的病理机制，骨密度是否存在差异。方法收集2012年1月至2023年7月在一家代谢骨诊所就诊的5岁及以上确诊为CP （GMFCS IV-V）和SMA （I-II型）的非门诊患者的数据。双能x线骨密度仪（DXA）评估腰椎（LS）和股骨外侧远端（LDF） 3区（R3）的骨密度。使用Wilcoxon秩和检验计算和比较组间z分数。结果本研究纳入了274例CP患儿和16例SMA患儿。两组未调整的LS z -评分均较低且具有可比性（CP: - 2.3, SMA: - 2.6; p = 0.7）。在调整身高后，LS - z得分在正常范围内（CP:−0.9,SMA:−1.6;p = 0.3）。然而，与CP组相比，SMA组LDF R3的骨密度显著降低（CP:−2.9,SMA:−3.9;p = 0.047）。结论两组高调LS骨密度正常，R3 LDF骨密度低，其中SMA组明显降低。我们推测，这可能是由于骨骼上肌肉紧张性的差异。我们建议将股骨远端骨密度纳入常规骨健康评估，并在可能的情况下根据身高调整骨密度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone Reports Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

4.00%

发文量

444

审稿时长

57 days

期刊介绍： Bone Reports is an interdisciplinary forum for the rapid publication of Original Research Articles and Case Reports across basic, translational and clinical aspects of bone and mineral metabolism. The journal publishes papers that are scientifically sound, with the peer review process focused principally on verifying sound methodologies, and correct data analysis and interpretation. We welcome studies either replicating or failing to replicate a previous study, and null findings. We fulfil a critical and current need to enhance research by publishing reproducibility studies and null findings.