Degree of functional capacity, bone mineral density and phosphocalcic metabolism alterations in paediatric patients with reduced mobility

Autor: C. Montoliu Peco, M.L. León Sánchez, A. Rodríguez González, E. Palomo Atance, L. Cuevas Moreno, J.R. Muñoz Rodríguez, M. Entrenas Valle, E. Medina Cano
Rok vydání: 2018
Předmět:
Zdroj: Annals of Physical and Rehabilitation Medicine. 61:e137
ISSN: 1877-0657
DOI: 10.1016/j.rehab.2018.05.304
Popis: Introduction/Background Mobility is essential for adequate bone mineralisation. Neuromuscular diseases can cause pathological fractures, bone pain, and a decrease in bone mineral density (BMD). Establish the association between BMD, phosphocalcic metabolism parameters, and degree of functional capacity. Material and method Observational, cross-sectional and prospective study in children under 18 with reduced mobility. The selection is performed by consecutive, non-randomised sampling. Variables analysed: age, gender, functional capacity according to the Functional Mobility Scale (FMS), which evaluates the ability to walk in 3 distances (5 metres, 50 metres and 500 metres) from 0 to 6, BMD (L2-L4) by DXA expressed in Z-scores according to bone age and gender, calcium, phosphorus, parathormone, 25-hydroxy-vitamin D3, alkaline phosphatase and osteocalcin in blood and calcium/creatinine ratio, tubular reabsorption of phosphorus and cross-linked N-terminal telopeptides of type I collagen in urine (NTX-I). Alkaline phosphatase, osteocalcin and NTX-I values are expressed in standard deviations according to reference values for age/gender. The results are analysed with the SPSS programme. Results Thirty-six patients (53% children), average age of 8.6 ± 4.7 years. Mean FMS value was 5.3 out of 18 (36% obtained a value of 0). Mean BMD was −1.99 ± 1.7, average alkaline phosphatase was −2.64 ± 1.08 SD, mean osteocalcin was −2.15 ± 1.39 SD, and mean NTX-I was +3 ± 1.72 SD. A significant association was observed between BMD and the FMS for the 5-metre distance (P = 0.017) and for the total score (P = 0.029), and between parathormone and the FMS at 5 (P = 0.041), 50 (P = 0.033) and 500 metres (P = 0.046). Conclusion There is a decrease in BMD and in bone neoformation markers such as alkaline phosphatase and osteocalcin in our population, and elevation of bone resorption markers such as NTX-I. Patients with a lower degree of mobility have a lower BMD.
Databáze: OpenAIRE
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