Objective To investigate the correlation of serum 25-hydroxyvitamin D [25-(OH)D] level with calf skeletal muscle development and gross motor function measure (GMFM) score in children with cerebral palsy(CP), in order to further provide reliable medical evidence to confirm the importance of adequate vitamin D level on the normal development of skeletal muscle system in CP children. Methods From December 2019 to January 2022, a total of 48 CP children with hemiplegia (n=24) and diplegia (n=24) who received rehabilitation treatment in Qinhuangdao Maternal and Child Health Hospital were enrolled in this study, and 24 typically developed children with the same age were selected as the control group. Calf muscle structure was measured by ultrasound at rest. GMFM scores were used to assess the standing and walking ability of children with CP. Serum 25-(OH)D level was determined by enzyme-linked immunosorbent assay. Results Serum 25-(OH)D level in hemiplegia group [(21.62±5.89)ng/ml] and diplegia group [(20.85±4.73)ng/ml] was significantly lower than that in control group [(27.93±5.20)ng/ml, P＜0.05]. For children with CP, the lateral gastrocnemius muscle fascicle length (FL) and soleus muscle thickness (MT) were correlated with GMFM score(r=0.414, 0.402, P＜0.05). Serum 25-(OH)D level of CP children was positively correlated with MT of tibialis anterior muscle (r=0.511, P＜0.001), MT of medial gastrocnemius muscle (r=0.394, P=0.006), MT of lateral gastrocnemius muscle (r=0.483, P=0.001), MT of soleus muscle (r=0.287, P=0.048) and GMFM (r=0.436, P=0.002). Further multivariate linear regression analysis showed that serum 25-(OH)D level was positively correlated with MT of tibialis anterior muscle (β=0.556, 95%CI:0.610 - 2.641, P=0.002), MT of lateral gastrocnemius muscle (β=0.492,95%CI:0.007 - 2.795,P=0.049) and GMFM (β=0.056, 95%CI:0.000 - 0.112, P=0.049). Conclusions The decrease of serum 25-(OH)D level in CP children is related to the dysplasia of calf muscle structure and the impairment of standing/walking ability. Therefore, vitamin D should be supplemented appropriately for CP children and targeted activities should be carried out in the early stage to optimize the adaptive changes of muscle structure and function.
Key words
cerebral palsy children /
25-(OH)D /
calf skeletal muscle development /
gross motor function
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