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 Statistics, The Ohio State University, Columbus, OH, United States.
Front Endocrinol (Lausanne). 2023 May 8;14:1124896. doi: 10.3389/fendo.2023.1124896. eCollection 2023.
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.
由于轻微/中度创伤导致的远端前臂骨折的发病率在事件年龄上呈双峰分布，在男孩和女孩中，一个高峰发生在青少年早期，另一个高峰发生在绝经后女性中。因此，本研究的目的是记录在年轻儿童中，骨密度与骨折之间的关系是否与青少年不同。
进行了一项配对病例对照研究，以评估 469 名年轻儿童和 387 名青少年的骨矿物质密度，他们均因轻微/中度创伤导致骨折/无骨折，并且保证比较组对结果事件的易感性相同。所有骨折均经放射学证实。该研究利用全身、脊柱、臀部和前臂的骨矿物质面积密度；前臂的体积骨矿物质密度；以及掌骨射线照相术测量。该研究控制了骨骼发育、骨几何形状、身体成分、手握力、钙摄入量和维生素 D 状态。
患有远端前臂骨折的青少年在多个感兴趣的骨骼区域的骨矿物质密度降低。这通过多个骨骼部位的骨矿物质面积密度测量值（p < 0.001）、前臂的体积骨矿物质密度测量值（p < 0.0001）和掌骨射线照相术（p < 0.001）得到证实。患有骨折的青少年女性的桡骨和掌骨的横截面积减小。患有骨折的年轻女性和男性儿童的骨骼状况与其对照组没有不同。与对照组相比，骨折病例中体脂增加更为普遍。大约 72%的骨折的年轻女性和男性儿童的血清 25-羟维生素 D 水平低于 31ng/ml 的阈值，而女性对照组只有 42%，男性对照组只有 51%。
患有脆性骨折的青少年在多个感兴趣的骨骼区域的骨矿物质密度降低，而年幼的儿童则没有这种情况。该研究的结果可能对预防该年龄段儿童的脆性骨折具有重要意义。
