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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Leticia Manning Ryan, Stephen J. Teach, Steven A. Singer, Rachel Wood, Robert Freishtat, Joseph L. Wright, Robert McCarter, Laura Tosi and James M. Chamberlain
Pediatrics September 2012, 130 (3) e553-e560; DOI: https://doi.org/10.1542/peds.2012-0134
Leticia Manning Ryan
aDivision of Emergency Medicine,
bCenter for Clinical and Community Research,
cDepartments of Integrative Systems Biology,
dPediatrics, and
eEmergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Stephen J. Teach
aDivision of Emergency Medicine,
bCenter for Clinical and Community Research,
dPediatrics, and
eEmergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Steven A. Singer
fDepartment of Emergency Medicine, George Washington University Medical Center, Washington, DC; and
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Rachel Wood
bCenter for Clinical and Community Research,
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Robert Freishtat
aDivision of Emergency Medicine,
cDepartments of Integrative Systems Biology,
dPediatrics, and
eEmergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Joseph L. Wright
aDivision of Emergency Medicine,
bCenter for Clinical and Community Research,
dPediatrics, and
eEmergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
gChild Health Advocacy Institute, and
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Robert McCarter
bCenter for Clinical and Community Research,
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Laura Tosi
hDivision of Orthopaedics and Sports Medicine, Children's National Medical Center, Washington, DC;
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James M. Chamberlain
aDivision of Emergency Medicine,
bCenter for Clinical and Community Research,
dPediatrics, and
eEmergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Abstract

OBJECTIVE: To determine whether African American children with forearm fractures have decreased bone mineral density and an increased prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D level ≤20 ng/mL) compared with fracture-free control patients.

METHODS: This case-control study in African American children, aged 5 to 9 years, included case patients with forearm fracture and control patients without fracture. Evaluation included measurement of bone mineral density and serum 25-hydroxyvitamin D level. Univariable and multivariable analyses were used to test for associations between fracture status and 2 measures of bone health (bone mineral density and 25-hydroxyvitamin D level) while controlling for other potential confounders.

RESULTS: The final sample included 76 case and 74 control patients. There were no significant differences between case and control patients in age, gender, parental education level, enrollment season, outdoor play time, height, or mean dietary calcium nutrient density. Cases were more likely than control patients to be overweight (49.3% vs 31.4%, P = .03). Compared with control patients, case patients had lower whole body z scores for bone mineral density (0.62 ± 0.96 vs 0.98 ± 1.09; adjusted odds ratio 0.38 [0.20–0.72]) and were more likely to be vitamin D deficient (47.1% vs 40.8%; adjusted odds ratio 3.46 [1.09–10.94]).

CONCLUSIONS: These data support an association of lower bone mineral density and vitamin D deficiency with increased odds of forearm fracture among African American children. Because suboptimal childhood bone health also negatively impacts adult bone health, interventions to increase bone mineral density and correct vitamin D deficiency are indicated in this population to provide short-term and long-term benefits.

KEY WORDS
  • fracture
  • injury
  • bone mineral density
  • vitamin D deficiency
  • Abbreviations:
    BMD —
    bone mineral density
    DXA —
    dual energy x-ray absorptiometry
    • Accepted May 10, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 3
    1 Sep 2012
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    Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures
    Leticia Manning Ryan, Stephen J. Teach, Steven A. Singer, Rachel Wood, Robert Freishtat, Joseph L. Wright, Robert McCarter, Laura Tosi, James M. Chamberlain
    Pediatrics Sep 2012, 130 (3) e553-e560; DOI: 10.1542/peds.2012-0134

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    Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures
    Leticia Manning Ryan, Stephen J. Teach, Steven A. Singer, Rachel Wood, Robert Freishtat, Joseph L. Wright, Robert McCarter, Laura Tosi, James M. Chamberlain
    Pediatrics Sep 2012, 130 (3) e553-e560; DOI: 10.1542/peds.2012-0134
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