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Bone Mineral Content and Bone Mineral Density Are Lower in Older than in Younger Females with Rett Syndrome.

Motil KJ, Ellis KJ, Barrish JO, Caeg E, Glaze DG

USDA/ARS Childrenʼs Nutrition Research Center [K.J.M., K.J.E.], Department of Pediatrics [K.J.M., K.J.E., J.O.B., E.C., D.G.G.], Department of Neurology [D.G.G.], Baylor College of Medicine, Houston, TX 77030.

Although bone mineral deficits have been identified in Rett syndrome (RTT), the prevalence of low bone mineral density and its association with skeletal fractures and scoliosis has not been characterized fully in girls and women with RTT. Accordingly, we measured total body bone mineral content (BMC) and bone mineral density (BMD) using dual energy x-ray absorptiometry in a cross-sectional group of 50 females, ages 2-38 y, with RTT. Methyl-CpG-binding 2 (MECP2) mutations, skeletal fractures, and scoliosis were documented. The prevalence of BMC and BMD z-scores <-2 SD was 59% and 45%, respectively. Although absolute BMC and BMD increased significantly with increasing age, BMC and BMD z-scores were significantly lower in older than in younger females. The prevalence of fractures and scoliosis was 28% and 64%, respectively. Low BMD z-scores were positively associated with fractures and scoliosis. Deficits in BMD were identified across a broad range of MECP2 mutations. This study identified associations among low bone mineral density, fractures, and scoliosis, and underscored the need for better understanding of the molecular mechanisms of MECP2 in the regulation of bone mineral metabolism.

Published 6 June 2008 in Pediatr Res.
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