This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This proposed research addresses the significant clinical problem of osteopenia in children with cerebral palsy (CP). Children with CP frequently grow slowly. The impact of this altered growth on skeletal development and bone density is a significant health problem. In normally growing children, the accrual of peak bone mass follows peak height velocity. However, in children with CP, differences in linear growth become more accentuated over time when compared to those of normally growing peers. In addition, as growth slows, the bone mineral density also falls further outside the range of normal. Optimizing the accrual of bone mass during pre-pubertal growth likely will affect peak bone mass during puberty. Bone growth, as assessed by bone mineral density, is an important aspect of growth in children with CP. In addition to diminished linear growth, children with CP often sustain painful, pathologic fractures due to poor mineralization of bone. This often occurs with minimal trauma. Thus, bone growth and bone density are highly relevant to overall linear growth, nutritional health, and health-related quality of life. Significantly decreased bone density is virtually universal in non-ambulatory children with moderate-severe CP after age 10. Predicting who is at the highest fracture risk is a challenge. Studies have found the rate of fractures in children with CP to range from 12-26%. Multiple factors predispose children with disabilities for fragility fractures. These include lack of weight bearing activity, muscle mass, calcium and phosphate homeostasis, nutrition, and medication use, especially glucocorticoids and anticonvulsants. The natural history of bone accrual into and through adolescence has not been the focus of prior research. The goal of this pilot proposal is to longitudinally evaluate height velocity and bone mineral density accrual in 50 pre-pubertal children with CP and compare to a cohort of typically growing children. The investigators will use two techniques to assess bone accrual rates. Dual energy X-ray absorptiometry (DXA) is a 2D technique for assessing bone density but is limited in its ability to capture changes in bone size/structure. Peripheral Quantitative Computed Tomography (pQCT) is a novel technique which measures 3-D bone structure/density. It may offer superior technique for capturing changes in bone size and will be compared to the rates of accrual determined by the more standard technique of DXA. No longitudinal research exists in the measurements of bone density and strength using pQCT in children with CP.

Agency
National Institute of Health (NIH)
Institute
National Center for Research Resources (NCRR)
Type
General Clinical Research Centers Program (M01)
Project #
5M01RR000847-36
Application #
7951514
Study Section
Special Emphasis Panel (ZRR1-CR-8 (01))
Project Start
2009-03-01
Project End
2010-02-28
Budget Start
2009-03-01
Budget End
2010-02-28
Support Year
36
Fiscal Year
2009
Total Cost
$13,650
Indirect Cost
Name
University of Virginia
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
065391526
City
Charlottesville
State
VA
Country
United States
Zip Code
22904
Campbell, Garland A; Patrie, James T; Gaylinn, Bruce D et al. (2018) Oral ghrelin receptor agonist MK-0677 increases serum insulin-like growth factor 1 in hemodialysis patients: a randomized blinded study. Nephrol Dial Transplant 33:523-530
Malin, Steven K; Rynders, Corey A; Weltman, Judy Y et al. (2016) Endothelial function following glucose ingestion in adults with prediabetes: Role of exercise intensity. Obesity (Silver Spring) 24:1515-21
Rynders, Corey A; Weltman, Judy Y; Malin, Steven K et al. (2016) Comparing Simple Insulin Sensitivity Indices to the Oral Minimal Model Postexercise. Med Sci Sports Exerc 48:66-72
Hu, Yinin; Kim, Helen; Blackwell, Christopher M et al. (2015) Long-term outcomes of helper peptide vaccination for metastatic melanoma. Ann Surg 262:456-64; discussion 462-4
Marozkina, Nadzeya V; Wang, Xin-Qun; Stsiapura, Vitali et al. (2015) Phenotype of asthmatics with increased airway S-nitrosoglutathione reductase activity. Eur Respir J 45:87-97
Nass, Ralf; Nikolayev, Alexander; Liu, Jianhua et al. (2015) The level of circulating octanoate does not predict ghrelin O-acyl transferase (GOAT)-mediated acylation of ghrelin during fasting. J Clin Endocrinol Metab 100:E110-3
Argo, Curtis K; Patrie, James T; Lackner, Carolin et al. (2015) Effects of n-3 fish oil on metabolic and histological parameters in NASH: a double-blind, randomized, placebo-controlled trial. J Hepatol 62:190-7
Chyun, Deborah A; Wackers, Frans J Th; Inzucchi, Silvio E et al. (2015) Autonomic dysfunction independently predicts poor cardiovascular outcomes in asymptomatic individuals with type 2 diabetes in the DIAD study. SAGE Open Med 3:2050312114568476
Nass, Ralf; Farhy, Leon S; Liu, Jianhua et al. (2014) Age-dependent decline in acyl-ghrelin concentrations and reduced association of acyl-ghrelin and growth hormone in healthy older adults. J Clin Endocrinol Metab 99:602-8
Hu, Yinin; Petroni, Gina R; Olson, Walter C et al. (2014) Immunologic hierarchy, class II MHC promiscuity, and epitope spreading of a melanoma helper peptide vaccine. Cancer Immunol Immunother 63:779-86

Showing the most recent 10 out of 674 publications