Bone Abstracts

Objective: To establish the difference between deficiency, insufficiency and normal results of vitamin D according to severity of motor function disorder and the level of bone mineral density in children with cerebral palsy.

Methods: Investigation encompassed 23 children, both genders, between 6 and 17 years of age, with diagnosed cerebral palsy, who were hospitalized between January 1 and December 31, 2014. Bone mineral density (BMD) was established using Dual-energy X-ray Absorptiometry – DXA method, at L1–L4 lumbar vertebrae and at the femur neck, and BMD results were analyzed according to criteria by ISCD Pediatric Position Statement from 2008. Severity of motor function disorder was assessed using Gross Motor Function Classification Scale (GMFCS). Vitamin D status was also analyzed. Normal values were defined as levels of 25(OH) D above 75 nmol/l. Deficiency of vitamin D was determined by values below 25 nmol/l and results between these two values as vitamin D insufficiency. A difference was analyzed between patients with insufficient, deficient and normal levels of vitamin D in correlation to BMD and GMFSC. In statistical analysis, descriptive statistics and Chi-square test were used.

Results: From total number of subjects, 56.5% were boys and 43.5% girls, with average age of 13±3.565 years, whose z-score of spine was −2.00±1.73, and z-score at the hip was −2.00±1.33. In half of patients levels of vitamin D were determined, and from those 58.3% were deficient, 41.7% insufficient, and no subjects had normal levels of vitamin D. Regarding GMFCS, there is no statistically significant difference between patients with vitamin D deficiency and insufficiency (χ²=3.36, df=1, P=0.067) although 100% of patients with vitamin D deficiency has Category V at GMFCS, while 40% patients with vitamin D insufficiency has Category IV at GMFCS, a 60% has Category V at GMFCS. Regarding BMD, there is no statistically significant difference (χ²=0.900, df=1, P=0.343) between patients with vitamin D deficiency and insufficiency, although all deficient patients also have osteoporosis.

Conclusion: Patients with lower level of vitamin D also have lower level of BMD and more severe cerebral palsy, pointing to the need for adequate supplementation of this vitamin.

Disclosure: The authors declared no competing interests.