A new study published in Brain & Development assessed the severity and pathology of osteoporosis in children and adults with severe motor and intellectual disabilities (SMID) by evaluating bone enzymes, with the objective of determining adequate treatment approaches for preventing fractures.

In this study, 90 patients – 44 men and 46 women, of mean age 34.5 years, underwent bone quality assessments. Quantitative ultrasonography (QUS) was used to measure the T-score and Z-score of the calcaneus, and blood samples were examined to measure bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase 5b levels as bone formation and resorption markers, as well as calcium, phosphorous and parathyroid hormone levels as routine examination.

It was found that bone formation and resorption marker levels were within normal ranges among adults although they were high during the growth period in children and adolescents, as well as in elderly women. In addition, patients receiving tube feeding showed a significantly lower Z-score than those without tube feeding. Tube feeding was a significant factor for the Z-score, whereas age, vitamin supplements and anti-epileptic drugs were not.

The results indicated that the severity of osteoporosis in SMID started during the growth period and could have been caused by a lack of an effective increase in bone mineral density. It was concluded that any treatment should be started during the growth period while more study about tube feeding is needed.

Source: Brain & Development. 2020 Jan 22. pii: S0387-7604(19)30718-1. doi: 10.1016/j.braindev.2019.12.010.