Vitamin D levels and fracture risk among Hispanic children

Ramírez, Norman; Ortiz-Fullana, Jose L; Arciniegas, Norma; Fullana, Altagracia; Valentín, Pablo; Orengo, Juan Carlos; Iriarte, Ivan; Carlo, Simón

doi:10.1007/s00590-018-2315-7

Cited by 8 publications

(10 citation statements)

References 27 publications

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“…20 In spite of its role in calcium homeostasis and the known link between 25(OH)D deficiency and rickets, the association between 25(OH)D deficiency and fracture risk has not been fully established. 4,[21][22][23][24][25][26][27][28][29][30] Some studies have examined the high prevalence of 25(OH)D deficiency among children with fractures, and a few of them compared children with fractures to "non-fractured" control subjects. 20,31 A recent meta-analysis by Yang et al 24 found an association between 25(OH)D insufficiency and a higher risk for fractures in children while other studies reported no association between vitamin D deficiency and fractures in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…20,31 A recent meta-analysis by Yang et al 24 found an association between 25(OH)D insufficiency and a higher risk for fractures in children while other studies reported no association between vitamin D deficiency and fractures in children and adolescents. 26,27 In some of the studies, the differences were subtle and only detected through complex multivariable analyses. 28 In other studies, significant confounders, such as skin color (and pigmentation) and BMI were not considered, nor included as predictors among matching criteria.…”

Section: Discussionmentioning

confidence: 99%

“…27 Moreover, the representation of an adolescent population with a high BMI existed in only a few studies. 22,26,32 Adolescents with overweight or obesity have been previously shown to have a higher likelihood of vitamin D deficiency. 9,32 Our findings support this premise, as 25(OH)D levels in the current cohort of adolescents with BMI ≥ 85th percentile were profoundly low, independent of having sustained a fracture.…”

Section: Discussionmentioning

confidence: 99%

“…27 Moreover, the representation of an adolescent population with a high BMI existed in only a few studies. 22,26,32…”

Section: Discussionmentioning

confidence: 99%

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Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity

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Ziv

Meisman

et al. 2022

Clin Pediatr (Phila)

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Adolescents with overweight/obesity are at risk for vitamin D insufficiency and deficiency. Both overweight/obesity and vitamin D insufficiency/deficiency may predispose to fractures. We enrolled 103 participants (53.3% females, 15.9 ± 2.2 years) in a retrospective case-control study to determine whether an association exists between fractures and a low 25-hydroxyvitamin D (25[OH]D) among adolescents whose body mass index (BMI) ≥ 85 percentile. Cases (n = 28) sustaining a low/medium impact fracture were matched to controls (n = 75) without a fracture history. A conditional-logistic regression analysis addressing the common vitamin D insufficiency/deficiency cutoffs was used. Overweight, obesity, and significant obesity rates were 10.7%, 53.4%, and 35.9%, respectively. Mean (±SD) 25(OH)D was 16.5 ± 6.4 ng/mL. In all, 25(OH)D insufficiency rates (level <20 ng/mL) were 70.5%. Matched cases and controls had similar 25(OH)D insufficiency/deficiency rates ( P > .05). Controlling for race and seasonality showed no association between fractures and 25(OH)D insufficiency/deficiency ( P > .05). These data suggest that fractures are not associated with low 25(OH)D levels among adolescents whose BMI ≥ 85th percentile.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…27 Moreover, the representation of an adolescent population with a high BMI existed in only a few studies. 22,26,32…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity

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Ziv

Meisman

et al. 2022

Clin Pediatr (Phila)

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“…13,14 In pediatric orthopaedics, early research has focused on the association between vitamin D and adolescent idiopathic scoliosis, spondylolysis, and fractures. [15][16][17][18][19][20][21][22][23][24][25][26] Recent publications on vitamin D deficiency as a potential risk factor for fractures have had inconsistent results. Cross-sectional studies on children with fractures of varying anatomic sites and races have reported hypovitaminosis D (25-OHD <30 ng/mL) from 34% to 65%.…”

mentioning

confidence: 99%

Pediatric Fractures: Does Vitamin D Play a Role?

Karkenny,

Avarello,

Hanstein

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Vitamin D (25-OHD) deficiency and insufficiency are reported in about half of all children. The literature on low 25-OHD and pediatric fracture risk presents inconsistent results. This study evaluates the association between pediatric fractures and 25-OHD, parathyroid hormone (PTH), and calcium. Methods: This is a prospective case-control study in 2 urban pediatric emergency departments (2014-2017). Patients aged 1 to 17 requiring intravenous access were enrolled. Demographics, nutrition, and activity information were recorded and levels of 25-OHD, calcium, and PTH were measured. Results: Two hundred forty-five subjects were enrolled: 123 fractures and 122 controls. Overall, the mean 25-OHD level was 23 ng/mL±8.5: 52 (21%) of patients were 25-OHD sufficient; 193 (79%) were not. Ninety-six percent of patients with lower extremity fractures had low 25-OHD versus 77% of patients with upper extremity fractures (P=0.024). The fracture cohort was younger (P=0.002), included more males (P=0.020), and spent more time playing outdoor sports (P=0.011) than the control cohort. The 25-OHD level (fracture 22.8 ng/mL±7.6 vs. nonfracture 23.5 ng/mL±9.3, P=0.494) and median calcium level (fracture 9.8 mg/dL vs. nonfracture 10.0 mg/dL, P=0.054) were similar between cohorts. The median PTH level was higher in the fracture than the control cohort (33 vs. 24.5 pg/mL; P<0.0005); PTH was elevated to hyperparathyroidism (>65 pg/mL) in 13% of fractures and 2% of controls (P=0.006). Matched subgroup analysis of 81 fracture patients and 81 controls by age, gender, and race showed that PTH was the only variable independently associated with increased odds of fracture (odds ratio=1.10, 95% CI, 1.01-1.19, P=0.021) in a model adjusted for vitamin D sufficiency and time spent playing outdoor sports. Conclusions: Low 25-OHD is common in children with fractures but we found no difference in 25-OHD levels between fracture and nonfracture cohorts. This research can impact evidence-based guidelines on vitamin D level screening and/or supplementation after fracture. Level of Evidence: Diagnostic level IV—case-control study.

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