Decreased bone mass in adolescents with bone fragility fracture but not in young children: a case-control study.
adolescents
bone mass
children
fragility fracture
vitamin D
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2023
2023
Historique:
received:
15
12
2022
accepted:
07
04
2023
medline:
26
5
2023
pubmed:
24
5
2023
entrez:
24
5
2023
Statut:
epublish
Résumé
The incidence of distal forearm fracture due to minimal/moderate trauma shows a bimodal distribution for age at event, with one peak occurring during early adolescence, in both boys and girls and the other one in postmenopausal females. The aim of this study was, therefore, to document whether the relationship between bone mineral density and fracture is different in young children compared with adolescents. A matched-pair, case-control study has been conducted to evaluate bone mineral density in 469 young children and 387 adolescents of both sexes, with/without fracture due to minimal/moderate trauma with assurance that the compared groups were equally susceptible to the outcome event. All fractures were radiographically confirmed. The study utilized bone mineral areal density of the total body, spine, hips, and forearm; volumetric bone mineral density of the forearm; and metacarpal radiogrammetry measurements. The study controlled for skeletal development, bone geometry, body composition, hand grip strength, calcium intake, and vitamin D status. Adolescents with distal forearm fracture have reduced bone mineral density at multiple skeletal regions of interest. This was documented by the bone mineral areal density measurements at multiple skeletal sites (p < 0.001), volumetric bone mineral density measurements of the forearm (p < 0.0001), and metacarpal radiogrammetry (p < 0.001). Adolescent females with fracture had reduced cross-sectional areas of the radius and metacarpals. The bone status of young female and male children with fracture was no different to its controls. Increased body fatness was more prevalent among fracture cases than in controls. Around 72% of young female and male children with fracture had serum 25-hydroxyvitamin D levels below the threshold of 31 ng/ml, compared with only 42% of female controls and to 51% of male controls. Adolescents with bone fragility fracture had reduced bone mineral density at multiple skeletal regions of interest, whereas this was not the case with younger children. The results of the study may have implications for the prevention of bone fragility in this segment of the pediatric population.
Sections du résumé
Background
The incidence of distal forearm fracture due to minimal/moderate trauma shows a bimodal distribution for age at event, with one peak occurring during early adolescence, in both boys and girls and the other one in postmenopausal females. The aim of this study was, therefore, to document whether the relationship between bone mineral density and fracture is different in young children compared with adolescents.
Methods
A matched-pair, case-control study has been conducted to evaluate bone mineral density in 469 young children and 387 adolescents of both sexes, with/without fracture due to minimal/moderate trauma with assurance that the compared groups were equally susceptible to the outcome event. All fractures were radiographically confirmed. The study utilized bone mineral areal density of the total body, spine, hips, and forearm; volumetric bone mineral density of the forearm; and metacarpal radiogrammetry measurements. The study controlled for skeletal development, bone geometry, body composition, hand grip strength, calcium intake, and vitamin D status.
Results
Adolescents with distal forearm fracture have reduced bone mineral density at multiple skeletal regions of interest. This was documented by the bone mineral areal density measurements at multiple skeletal sites (p < 0.001), volumetric bone mineral density measurements of the forearm (p < 0.0001), and metacarpal radiogrammetry (p < 0.001). Adolescent females with fracture had reduced cross-sectional areas of the radius and metacarpals. The bone status of young female and male children with fracture was no different to its controls. Increased body fatness was more prevalent among fracture cases than in controls. Around 72% of young female and male children with fracture had serum 25-hydroxyvitamin D levels below the threshold of 31 ng/ml, compared with only 42% of female controls and to 51% of male controls.
Conclusions
Adolescents with bone fragility fracture had reduced bone mineral density at multiple skeletal regions of interest, whereas this was not the case with younger children. The results of the study may have implications for the prevention of bone fragility in this segment of the pediatric population.
Identifiants
pubmed: 37223040
doi: 10.3389/fendo.2023.1124896
pmc: PMC10200873
doi:
Substances chimiques
Minerals
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1124896Subventions
Organisme : NCRR NIH HHS
ID : UL1 RR025755
Pays : United States
Informations de copyright
Copyright © 2023 Matkovic, Goel, Mobley, Badenhop-Stevens, Ha, Li, Skugor and Clairmont.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
JAMA. 1982 Jan 15;247(3):326-31
pubmed: 7033572
Skeletal Radiol. 1996 Jul;25(5):431-9
pubmed: 8837274
Calcif Tissue Int. 1997 Aug;61(2):104-9
pubmed: 9312397
J Clin Invest. 1994 Feb;93(2):799-808
pubmed: 8113412
J Clin Endocrinol Metab. 2009 Feb;94(2):559-63
pubmed: 19033372
J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30
pubmed: 21646368
J Pediatr. 2001 Oct;139(4):509-15
pubmed: 11598596
Pediatrics. 2006 Feb;117(2):e291-7
pubmed: 16452336
Mayo Clin Proc. 1979 Nov;54(11):701-7
pubmed: 491761
J Bone Miner Res. 2008 Jul;23(7):1012-22
pubmed: 18570539
J Nutr. 2004 Mar;134(3):701S-705S
pubmed: 14988471
J Bone Joint Surg Am. 1989 Sep;71(8):1225-31
pubmed: 2777851
J Clin Endocrinol Metab. 1997 Oct;82(10):3239-45
pubmed: 9329346
Am J Clin Nutr. 2005 Jan;81(1):175-88
pubmed: 15640478
Bone. 2009 Sep;45(3):480-6
pubmed: 19481189
J Bone Miner Res. 1998 Jan;13(1):143-8
pubmed: 9443800
Clin Orthop Relat Res. 1983 Sep;(178):292-6
pubmed: 6883863
J Bone Miner Res. 2011 Feb;26(2):380-7
pubmed: 20721933
Rev Endocr Metab Disord. 2008 Jun;9(2):161-70
pubmed: 18175220
Pediatrics. 1980 Dec;66(6):918-20
pubmed: 7454482
J Bone Miner Res. 2006 Apr;21(4):501-7
pubmed: 16598368
Am J Dis Child. 1984 Jun;138(6):569-70
pubmed: 6720643
Acta Orthop. 2016 Jun;87(3):296-300
pubmed: 26905618
J Bone Miner Res. 2001 Jul;16(7):1337-42
pubmed: 11450710
J Clin Endocrinol Metab. 2003 Apr;88(4):1486-91
pubmed: 12679427
J Bone Joint Surg Am. 2011 Feb 16;93(4):348-56
pubmed: 21325586
Osteoporos Int. 1994 Nov;4(6):382-98
pubmed: 7696836
J Bone Joint Surg Am. 1962 Jan;44-A:105-14
pubmed: 14036674
J Bone Miner Res. 2000 Oct;15(10):2011-8
pubmed: 11028455
J Am Diet Assoc. 2004 Feb;104(2):250-3
pubmed: 14760576
J Pediatr Orthop. 1987 Jul-Aug;7(4):424-7
pubmed: 3611339
J Bone Miner Res. 2006 Sep;21(9):1489-95
pubmed: 16939408
J Bone Miner Res. 2007 Sep;22(9):1463-7
pubmed: 17501666
Acta Orthop Scand Suppl. 1983;202:1-109
pubmed: 6574687
Bone. 2006 Sep;39(3):652-7
pubmed: 16765659
Am J Clin Nutr. 2002 Sep;76(3):675-80
pubmed: 12198017
JAMA. 2003 Sep 17;290(11):1479-85
pubmed: 13129988
J Bone Miner Res. 2008 Feb;23(2):173-9
pubmed: 17922615
Arch Pediatr. 2022 May;29(4):312-325
pubmed: 35305879
J Bone Miner Res. 2010 Mar;25(3):527-36
pubmed: 19778184
Osteoporos Int. 2011 Feb;22(2):607-16
pubmed: 20571770
J Bone Miner Res. 2005 Dec;20(12):2090-6
pubmed: 16294262
JAMA. 2004 Apr 28;291(16):1999-2006
pubmed: 15113819