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Risk of fracture prevention in spina bifida patients: correlation between bone mineral density, vitamin D, and electrolyte values

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Abstract

Purpose

The aim of our study was to investigate the relationship between bone mineral density (BMD), vitamin D, and electrolyte blood values in patients with spina bifida, to find a possible therapeutic regimen and an intervention to reduce the risk of fractures in this population.

Methods

BMD values were measured in 49 patients (32 females, 17 males; aged 14.1 ± 3.86 years; range 5–20 years) using dual-energy X-ray absorptiometry (DEXA) and were analyzed based on sex, the level of spinal involvement, vitamin D, and electrolyte values, physical activity, body mass index (BMI), and ambulatory status [patients were divided into three subgroups: full-time wheelchair (FTWC), limited ambulator (LA), and full-time ambulator (FTA)]. These data were analyzed considering sex-, age-, and BMD-matched values and compared with those of normal population.

Results

BMD was significantly lower in these patients compared with that in the general healthy population (Z-score: −1.2 ± 1.8); in particular, females had Z-score values significantly lower that of the males (Z-score: −2.43 ± 2.02; P < 0.0004). In FTWC subgroup, Z-score was lower than that of the other two subgroups (P < 0.009). Vitamin D values were significantly lower compared with those in the general healthy population (vitamin D spina bifida group: 14.6 ± 8.7 mg/dL; normal subjects: 35 ± 9.8 mg/dL; P < 0.001). Subjects with spina bifida showed hypophosphatemia (<3 mg/dL) because of the lower levels of vitamin D (3.1 ± 0.9 mg/dL; P < 0.001).

Conclusions

Spina bifida patients showed lower BMD, vitamin D, and electrolyte values than the healthy population; hence, they have an increase risk of developing pathological fractures. Vitamin D supplementation for a longer time period could reduce this risk.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Bioimaging and Radiological Sciences, Catholic University, 00168, Rome, Italy

    V. Martinelli, C. Dell’Atti, E. Federici, N. Magarelli, A. Leone & L. Bonomo

  2. Department of Pediatry, Catholic University, 00168, Rome, Italy

    E. Ausili & C. Rendeli

  3. Department of Pediatric Neurosurgery, Catholic University, 00168, Rome, Italy

    L. Massimi & C. Di Rocco

  4. Via Ferruccio Zambonini, 23, 00158, Rome, Italy

    V. Martinelli

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  1. V. Martinelli
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  2. C. Dell’Atti
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  3. E. Ausili
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  4. E. Federici
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  5. N. Magarelli
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  6. A. Leone
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  7. L. Massimi
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  8. C. Di Rocco
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  9. L. Bonomo
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  10. C. Rendeli
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Correspondence to V. Martinelli.

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Martinelli, V., Dell’Atti, C., Ausili, E. et al. Risk of fracture prevention in spina bifida patients: correlation between bone mineral density, vitamin D, and electrolyte values. Childs Nerv Syst 31, 1361–1365 (2015). https://doi.org/10.1007/s00381-015-2726-2

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  • DOI: https://doi.org/10.1007/s00381-015-2726-2

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