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Adults with cerebral palsy have higher prevalence of fracture compared to adults without cerebral palsy independent of osteoporosis and cardiometabolic diseases.

07:00 EST 7th February 2019 | BioPortfolio

Summary of "Adults with cerebral palsy have higher prevalence of fracture compared to adults without cerebral palsy independent of osteoporosis and cardiometabolic diseases."

Individuals with cerebral palsy (CP) have increased risk of fracture throughout their lifespan due to an underdeveloped musculoskeletal system, excess body fat, diminished mechanical loading, and early development of noncommunicable diseases. However, the epidemiology of fracture among adults with CP is unknown. The purpose of this cross-sectional study was to determine the prevalence of fracture among a large sample of privately-insured adults with CP, as compared to adults without CP. Data were from the Optum Clinformatics® Data Mart, a de-identified nationwide claims database of beneficiaries from a single private payer. Diagnostic codes were used to identify 18-64 year old beneficiaries with and without CP, as well as any fracture, which consisted of osteoporotic pathological fracture and any type of fracture of the head/neck, thoracic, lumbar/pelvic, upper extremity, and lower extremity regions. The prevalence of any fracture was compared between adults with (n = 5,555) and without (n = 5.5 million) CP. Multivariable logistic regression was performed with all-cause fracture as the outcome and CP group as the primary exposure. Adults with CP had a higher prevalence of all-cause fracture (6.3%, 2.7%, respectively) and fracture of the head/neck, thoracic, lumbar/pelvic, upper extremity, and lower extremity regions compared to adults without CP (all, p < 0.01). After adjusting for sociodemographic and socioeconomic variables, adults with CP had higher odds of all-cause fracture compared to adults without CP (OR = 2.5; 95%CI = 2.2-2.7). After further adjusting for cardiometabolic diseases, adults with CP had higher odds of all-cause fracture compared to adults without CP (OR = 2.2; 95%CI = 2.0-2.5). After further adjusting for osteoporosis, adults with CP still had higher odds of all-cause fracture compared to adults without CP (OR = 2.0; 95%CI = 1.8-2.2). These findings suggest that young and middle-aged adults with CP have an elevated prevalence of all-cause fracture compared to adults without CP, which was present even after accounting for cardiometabolic diseases and osteoporosis. This article is protected by copyright. All rights reserved.

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This article was published in the following journal.

Name: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
ISSN: 1523-4681
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Medical and Biotech [MESH] Definitions

A rare central nervous system demyelinating condition affecting children and young adults. Pathologic findings include a large, sharply defined, asymmetric focus of myelin destruction that may involve an entire lobe or cerebral hemisphere. The clinical course tends to be progressive and includes dementia, cortical blindness, cortical deafness, spastic hemiplegia, and pseudobulbar palsy. Concentric sclerosis of Balo is differentiated from diffuse cerebral sclerosis of Schilder by the pathologic finding of alternating bands of destruction and preservation of myelin in concentric rings. Alpers' Syndrome refers to a heterogeneous group of diseases that feature progressive cerebral deterioration and liver disease. (From Adams et al., Principles of Neurology, 6th ed, p914; Dev Neurosci 1991;13(4-5):267-73)

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