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Eastern Regional Meeting - 2008 Program & Abstracts
Back to 2008 Program
VITAMIN D INSUFFICIENCY IN AFRICAN AMERICAN CHILDREN WITH FOREARM FRACTURES
L.M. Ryan, R. Freishtat, J. Wright, J. Chamberlain, Emergency Medicine, Children's National Medical Center, Washington, DC; L.M. Ryan, J. Wright, J. Chamberlain, Research Center for Health Services and Community Research, Children's National Medical Center, Washington, DC; C. Brandoli, L. Tosi, Orthopaedics and Sports Medicine, Children's National Medical Center, Washington, DC; R. Freishtat, E. Hoffman, Research Center for Genetic Medicine, Children's National Medical Center, Washington, DC; J. Wright, Child Health Advocacy Institute, Children's National Medical Center, Washington, DC
Purpose of Study: Half of all children fracture a bone; of those, nearly 40% sustain additional fractures. Fracture rates are increasing. Poor vitamin D status increases fracture risk in infants and adults. The relationship between vitamin D status and childhood fractures has not been investigated. We hypothesize that pediatric fracture cases have an increased prevalence of vitamin D insufficiency compared to fracture-free controls.
Methods Used: This case-control study is enrolling cases (African American children, ages 5-9 years, with forearm fracture) and fracture-free controls. Evaluation includes measurement of serum 25-hydroxy vitamin D level and BMD by dual energy xray absorptiometry (DXA) scan. Univariable and multivariable analyses are used to test the associations between fracture status and the independent variables serum vitamin D level and BMD with control for confounders.
Summary of Results: To date, 31 cases and 7 controls are enrolled. The mean + SD case age is 7.2 + 1.4 years; 55% are male. The mean control age is 6.4 + 1.3 years; 57% are male. The mean 25-hydroxy vitamin D level for cases is 21.5 + 7 ng/mL (n=23). This mean is at the cutpoint for vitamin D insufficiency [serum 25-hydroxy vitamin D level < 20 ng/mL]. Ten cases (43%) are vitamin D insufficient. The mean 25-hydroxy vitamin D level for controls is 29 + 3.3 ng/mL (n=4) which is significantly higher (p=0.049). No controls are vitamin D insufficient. The mean whole body z-score for cases is 0.6 + 0.9 (n=27). The mean whole body z-score for controls is 0.3 + 0.9 (n=5) which is not significantly different (p=0.48). All DXA scan results are consistent with normal bony mineralization for age (z-score > -2).
Conclusions: A significant proportion of cases in our ongoing study are vitamin D insufficient. Mean serum vitamin D levels are also lower in cases compared to controls. Vitamin D insufficiency may play a previously unrecognized role in childhood fractures.
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