Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review.

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY Developmental Medicine and Child Neurology Pub Date : 2025-01-17 DOI:10.1111/dmcn.16234

Anne Trinh, Ellen Fremion, Shayan Bhathena, Craig F Munns, Prue Morgan, Daniel G Whitney, Bernadette Gillick, Margaret Zacharin, Darcy Fehlings, Amanda J Vincent, Frances Milat

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Abstract

Aim: To systematically review the prevalence and incidence of osteoporosis, osteopenia, low bone mass, and fragility fracture in adults with cerebral palsy (CP), and identify the risk factors for osteoporosis and fracture.

Method: A systematic literature search was performed in the MEDLINE, PubMed, CINAHL, AMED, Cochrane Reviews, EMBASE, and EBM database reviews from inception until May 2024. Search terms covered a combination of keywords for CP, fracture, osteoporosis, incidence and prevalence, and risk factors. Participants were adults with CP aged 18 years and older. JBI critical appraisal instruments were used to assess quality and risk of bias.

Results: Seventeen of 303 studies met the eligibility criteria to assess the prevalence and incidence of osteoporosis and fracture, and 16 of 663 studies to assess risk factors. Osteoporosis prevalence was 5% in a general adult population with CP, increasing to 43% in those attending outpatient clinics. Osteoporosis incidence reported in one study was 2.85 per 1000 person years. Prevalence of fragility fracture was 5.5% overall but up to 38% in outpatient settings. Risk factors for osteoporosis and fracture included mobility status, nutritional status, and anticonvulsant use.

Interpretation: Low bone density and fracture is common in adults with CP with reduced mobility. The main risk factors for poor bone health are related to reduced mobility, nutrition, and anticonvulsant use.

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成人脑瘫患者骨质疏松和脆性骨折的患病率及危险因素：一项系统综述。

目的：系统回顾成人脑瘫（CP）患者骨质疏松、骨质减少、低骨量和脆性骨折的患病率和发病率，并探讨其发生骨质疏松和骨折的危险因素。方法：系统检索MEDLINE、PubMed、CINAHL、AMED、Cochrane Reviews、EMBASE和EBM数据库综述，检索时间从数据库建立到2024年5月。搜索词包括CP、骨折、骨质疏松症、发病率和患病率以及危险因素的组合。参与者为18岁及以上患有CP的成年人。使用JBI关键评价工具评估偏倚的质量和风险。结果：303项研究中有17项符合评估骨质疏松和骨折患病率和发生率的资格标准，663项研究中有16项符合评估危险因素的资格标准。骨质疏松症患病率在普通成年CP人群中为5%，在门诊就诊的人群中增加到43%。一项研究报告的骨质疏松发病率为每1000人年2.85例。脆性骨折的患病率为5.5%，但在门诊的患病率高达38%。骨质疏松和骨折的危险因素包括活动能力状况、营养状况和抗惊厥药的使用。结论：低骨密度和骨折在活动能力降低的CP成人中很常见。骨骼健康不良的主要危险因素与活动能力降低、营养不良和抗惊厥药的使用有关。

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

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.