New research from the Texas A&M College of Veterinary Medicine and Biomedical Sciences has provided direct experimental evidence that people with Down syndrome cannot recover from bone fractures.
The study, published in the scientific journal Bone, not only addresses an unknown issue, but also highlights the need for clinicians to better address the issue of fracture healing in people with Down syndrome.
Down syndrome, the most common birth defect, impairs human development and results in a number of clinical problems, including mental decline, joint dysfunction, heart defects, sleep apnea and infertility.
Previous research has also indicated that people with Down syndrome have lower bone density, which increases the likelihood of bone fractures. Scientists previously assumed that the fracture-healing response would be different in people with Down syndrome, but the finding that fractures do not heal in Down syndrome was “amazing.”
“Scientists have long studied fractures in many different species, and while healing can be slow in some cases, most fractures eventually heal in all species. In our research, the fracture did not heal at all. When When the bones heal, a soft callus of cartilage forms, a type of glue that holds the broken ends together. In a model with Down syndrome, gum begins to form, but it never bridges the gap. would not have been able to.”, explains Kirby Sherman, one of the leaders of the study.
This is worrying, according to the researchers, because a fracture that doesn’t heal completely can have devastating health consequences, made worse for people with Down syndrome due to the apparent loss of bone density. “Based on this, fracture risk is a significant health concern for the Down syndrome community,” Sherman says.
“A fracture that doesn’t heal properly, what we call a nonunion, can kill people, whether they have Down syndrome or not. If this population really has a higher nonunion rate than the general population, So that’s a big problem,” said one of the description writers, Larry Suva.
According to Suva and Sherman, there are two main reasons for this problem to go unnoticed so far; The first is that people with Down syndrome live longer than previously thought.
According to the US Centers for Disease Control and Prevention (CDC), the life expectancy of people with Down syndrome in 1960 was only 10 years. In 2007, as more was learned and applied to offset the endocrine effects of Down syndrome, life expectancy increased to 47 years.
“We know that this population has low bone mass, and the increased life expectancy of this population has allowed researchers to better understand the long-term effects of their lower bone mass. Today, there are people with Down syndrome. Those down in their 20s and 30s who have more bone mass and bone architecture than someone in their 60s are active members of the community and play sports. Obviously that’s great, but if they have bone My risk of fractures increases if I don’t recover, which is also worrying,” Suva says.
Another reason this problem has gone unnoticed for so long is that doctors and hospitals have not taken into account the specialized care for people with Down syndrome, meaning there was no data available to identify the problem.
“There is no medical code that identifies people with Down syndrome, so the researchers did not have any kind of database to collect the data to support this type of research. The Down syndrome support group Down and Family Members don’t want their loved ones or themselves to be isolated for having a disease. After all, they are normal people,” says Suva.
The next step in research will be to attempt to find these human data, focusing on the actual mechanisms that impede fracture healing. Since no one knew this was a problem, no one was looking for a solution.
In the meantime, with this new awareness of the problem, researchers hope that measures to increase bone strength will be more widely adopted, more careful monitoring of fractures, and bone health of doctors and other women. Will keep it in mind. with Down syndrome.
“We want doctors to tell patients, ‘You’re 17; you can still play football and be active.’ But we also want to make sure these patients have good diets and vitamin D levels, to do these things that are suggested for skeletal health. That’s our goal,” says Suva.