Decreased bone mass in adolescents with bone fragility fracture but not in young children: a case–control study

Frontiers in Endocrinology

Endocrinology

Velimir Matkovic¹  Prem Goel¹  Nancy E. Badenhop-Stevens¹  Albert Clairmont²  Mario Skugor³  Bin Li⁴  Stacey L. Mobley⁵  Eun-Jeong Ha⁶ 

[1] Bone and Mineral Metabolism Laboratory, Departments of Physical Medicine and Rehabilitation (PMR), Medicine, and Nutrition, The Ohio State University, Columbus, OH, United States;Department of Endocrinology, Cleveland Clinic, Cleveland, OH, United States;Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, United States;Department of Nutrition, Kent State University, Kent, OH, United States;Department of Statistics, The Ohio State University, Columbus, OH, United States;Food Sciences and Human Nutrition Department, University of Florida, Gainesville, FL, United States;

关键词: bone mass;    fragility fracture;    children;    adolescents;    vitamin D;   

DOI  :  10.3389/fendo.2023.1124896

 received in 2022-12-15, accepted in 2023-04-07,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe 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.MethodsA 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.ResultsAdolescents 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.ConclusionsAdolescents 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.

【 授权许可】

Unknown   
Copyright © 2023 Matkovic, Goel, Mobley, Badenhop-Stevens, Ha, Li, Skugor and Clairmont