Trabecular bone score in adults with cerebral palsy

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Context: Bone fragility in cerebral palsy (CP) is secondary to a complex interplay of functional, hormonal, and nutritional factors that affect bone remodelling. A greater understanding of bone microarchitectural changes seen in CP should assist therapeutic decision making. Objective: To examine the relationship between trabecular bone score (TBS), BMD and fractures in adults with CP; the influence of clinical factors and body composition on bone microarchitecture were explored. Design: Retrospective cross-sectional study. Setting and Participants: 43 adults (25 male) with CP of median age 25 years (interquartile range 21.4–33.9) who had evaluable dual-energy X-ray absorptiometry imaging of the lumbar spine from a single tertiary hospital between 2005-March 2018. Results: 24/43 (55.8%) of patients had TBS values indicating intermediate or high risk of fracture (<1.31). TBS correlated with areal BMD at the lumbar spine, femoral neck and total body. TBS was significantly associated with arm and leg lean mass, with adjustment for age, gender and height (adjusted R2 = 0.18, p = 0.042 for arm lean mass; adjusted R2 = 0.19, p = 0.036 for leg lean mass). There was no difference in TBS when patients were grouped by fracture status, anticonvulsant use, gonadal status or use of PEG feeding. TBS was lower in non-ambulatory patients compared with ambulatory patients (1.28 vs 1.37, p = 0.019). Conclusions: Abnormal bone microarchitecture, as measured by TBS, was seen in >50% of young adults with CP. TBS correlated with both areal BMD and appendicular lean mass. Maintaining muscle function is likely to be important for bone health in young adults with CP and needs to be confirmed in further studies.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalBone
Volume117
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • Cerebral palsy
  • Fracture
  • Immobilization
  • Microarchitecture
  • Osteoporosis
  • Sarcopenia
  • Trabecular bone score

Cite this

@article{d5e1b3d95cbf4616805b4b575668cb09,
title = "Trabecular bone score in adults with cerebral palsy",
abstract = "Context: Bone fragility in cerebral palsy (CP) is secondary to a complex interplay of functional, hormonal, and nutritional factors that affect bone remodelling. A greater understanding of bone microarchitectural changes seen in CP should assist therapeutic decision making. Objective: To examine the relationship between trabecular bone score (TBS), BMD and fractures in adults with CP; the influence of clinical factors and body composition on bone microarchitecture were explored. Design: Retrospective cross-sectional study. Setting and Participants: 43 adults (25 male) with CP of median age 25 years (interquartile range 21.4–33.9) who had evaluable dual-energy X-ray absorptiometry imaging of the lumbar spine from a single tertiary hospital between 2005-March 2018. Results: 24/43 (55.8{\%}) of patients had TBS values indicating intermediate or high risk of fracture (<1.31). TBS correlated with areal BMD at the lumbar spine, femoral neck and total body. TBS was significantly associated with arm and leg lean mass, with adjustment for age, gender and height (adjusted R2 = 0.18, p = 0.042 for arm lean mass; adjusted R2 = 0.19, p = 0.036 for leg lean mass). There was no difference in TBS when patients were grouped by fracture status, anticonvulsant use, gonadal status or use of PEG feeding. TBS was lower in non-ambulatory patients compared with ambulatory patients (1.28 vs 1.37, p = 0.019). Conclusions: Abnormal bone microarchitecture, as measured by TBS, was seen in >50{\%} of young adults with CP. TBS correlated with both areal BMD and appendicular lean mass. Maintaining muscle function is likely to be important for bone health in young adults with CP and needs to be confirmed in further studies.",
keywords = "Cerebral palsy, Fracture, Immobilization, Microarchitecture, Osteoporosis, Sarcopenia, Trabecular bone score",
author = "Anne Trinh and Phillip Wong and Fahey, {Michael C} and Ebeling, {Peter Robert} and Fuller, {Peter J} and Frances Milat",
year = "2018",
month = "12",
day = "1",
doi = "10.1016/j.bone.2018.09.001",
language = "English",
volume = "117",
pages = "1--5",
journal = "Bone",
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}

Trabecular bone score in adults with cerebral palsy. / Trinh, Anne; Wong, Phillip; Fahey, Michael C; Ebeling, Peter Robert; Fuller, Peter J; Milat, Frances.

In: Bone, Vol. 117, 01.12.2018, p. 1-5.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Trabecular bone score in adults with cerebral palsy

AU - Trinh, Anne

AU - Wong, Phillip

AU - Fahey, Michael C

AU - Ebeling, Peter Robert

AU - Fuller, Peter J

AU - Milat, Frances

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Context: Bone fragility in cerebral palsy (CP) is secondary to a complex interplay of functional, hormonal, and nutritional factors that affect bone remodelling. A greater understanding of bone microarchitectural changes seen in CP should assist therapeutic decision making. Objective: To examine the relationship between trabecular bone score (TBS), BMD and fractures in adults with CP; the influence of clinical factors and body composition on bone microarchitecture were explored. Design: Retrospective cross-sectional study. Setting and Participants: 43 adults (25 male) with CP of median age 25 years (interquartile range 21.4–33.9) who had evaluable dual-energy X-ray absorptiometry imaging of the lumbar spine from a single tertiary hospital between 2005-March 2018. Results: 24/43 (55.8%) of patients had TBS values indicating intermediate or high risk of fracture (<1.31). TBS correlated with areal BMD at the lumbar spine, femoral neck and total body. TBS was significantly associated with arm and leg lean mass, with adjustment for age, gender and height (adjusted R2 = 0.18, p = 0.042 for arm lean mass; adjusted R2 = 0.19, p = 0.036 for leg lean mass). There was no difference in TBS when patients were grouped by fracture status, anticonvulsant use, gonadal status or use of PEG feeding. TBS was lower in non-ambulatory patients compared with ambulatory patients (1.28 vs 1.37, p = 0.019). Conclusions: Abnormal bone microarchitecture, as measured by TBS, was seen in >50% of young adults with CP. TBS correlated with both areal BMD and appendicular lean mass. Maintaining muscle function is likely to be important for bone health in young adults with CP and needs to be confirmed in further studies.

AB - Context: Bone fragility in cerebral palsy (CP) is secondary to a complex interplay of functional, hormonal, and nutritional factors that affect bone remodelling. A greater understanding of bone microarchitectural changes seen in CP should assist therapeutic decision making. Objective: To examine the relationship between trabecular bone score (TBS), BMD and fractures in adults with CP; the influence of clinical factors and body composition on bone microarchitecture were explored. Design: Retrospective cross-sectional study. Setting and Participants: 43 adults (25 male) with CP of median age 25 years (interquartile range 21.4–33.9) who had evaluable dual-energy X-ray absorptiometry imaging of the lumbar spine from a single tertiary hospital between 2005-March 2018. Results: 24/43 (55.8%) of patients had TBS values indicating intermediate or high risk of fracture (<1.31). TBS correlated with areal BMD at the lumbar spine, femoral neck and total body. TBS was significantly associated with arm and leg lean mass, with adjustment for age, gender and height (adjusted R2 = 0.18, p = 0.042 for arm lean mass; adjusted R2 = 0.19, p = 0.036 for leg lean mass). There was no difference in TBS when patients were grouped by fracture status, anticonvulsant use, gonadal status or use of PEG feeding. TBS was lower in non-ambulatory patients compared with ambulatory patients (1.28 vs 1.37, p = 0.019). Conclusions: Abnormal bone microarchitecture, as measured by TBS, was seen in >50% of young adults with CP. TBS correlated with both areal BMD and appendicular lean mass. Maintaining muscle function is likely to be important for bone health in young adults with CP and needs to be confirmed in further studies.

KW - Cerebral palsy

KW - Fracture

KW - Immobilization

KW - Microarchitecture

KW - Osteoporosis

KW - Sarcopenia

KW - Trabecular bone score

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U2 - 10.1016/j.bone.2018.09.001

DO - 10.1016/j.bone.2018.09.001

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