ACKNOWLEDGEMENTS We acknowledge the support of the Rehabilitation Research & Development Service for the Center of Excellence for the Medical Consequences of Spinal Cord Injury (Department of Veterans Affairs No. B4162C) and of the James J Peters Veterans Affairs Medical Center, Bronx, NY. I would also like to thank Dr Therese Johnston for her comments and suggestions during preparation of this manuscript.
The potential metabolic consequences of cerebral palsy: inferences from the general population and persons with spinal cord injury
Article first published online: 3 SEP 2009
© 2009 Mac Keith Press No claim to original government works
Developmental Medicine & Child Neurology
Special Issue: Adults with Cerebral Palsy: A workshop to define the challenges of treating and preventing the secondary musculoskeletal and neuromuscular complications in this rapidly growing population.
Volume 51, Issue Supplement s4, pages 64–78, October 2009
How to Cite
BAUMAN, W. A. (2009), The potential metabolic consequences of cerebral palsy: inferences from the general population and persons with spinal cord injury. Developmental Medicine & Child Neurology, 51: 64–78. doi: 10.1111/j.1469-8749.2009.03430.x
CONFLICTS OF INTEREST The author declares no conflicts of interest.
- Issue published online: 3 SEP 2009
- Article first published online: 3 SEP 2009
The metabolic consequences of cerebral palsy (CP) have not been reported. The observations and suggestions presented in this article are based on our current knowledge of physiology in the general population and on information on the known metabolic consequences of disability in persons with spinal cord injury. Because of pain, fatigue, and other secondary consequences of CP, adolescents with CP who are ambulatory may become less physically active with age. This phenomenon would be expected to be associated with deconditioning and adverse changes in body composition including atrophy of muscles and an absolute or relative increase in adiposity. Insulin resistance, hyperinsulinemia, and associated adverse metabolic changes may develop. In an unfavorable metabolic milieu, the ability of the pancreas to compensate for mild elevations of circulating glucose may diminish. The combination of reduced fitness and conventional risk factors for cardiovascular disease would be expected to increase the risk for coronary heart disease (CHD); however, there has been no assessment of the risk factors for CHD in adults with CP. Once subgroups with modifiable risk factors for cardiovascular disease have been identified, risk factors for CHD should be aggressively treated, according to current standards of care.