Vitamin D level and low-energy fracture risk in children and adolescents: a population-based case-control study of 45 cases

The objective of this study is to document the rate of vitamin D deficiency and insufficiency among children with low-energy fractures and compare it to fracture-free control group. We included all children under 15 years presenting to the emergency department with low-energy fractures; controls wer...

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Main Authors: Assaf, Elio (Author) , Nicolas, Georges (Author) , Hoyek, Fadi (Author) , Abi Fares, Georges (Author) , Lahoud, Jean Claude (Author) , Hajj, Rabih (Author) , Mohs, Elisabeth (Author) , Dally, Franz-J. (Author) , Hetjens, Svetlana (Author) , Gravius, Sascha (Author) , Darwich, Ali (Author)
Format: Article (Journal)
Language:English
Published: July 2024
In: Journal of pediatric orthopaedics
Year: 2024, Volume: 33, Issue: 4, Pages: 392-398
ISSN:1473-5865
DOI:10.1097/BPB.0000000000001061
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/BPB.0000000000001061
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/jpo-b/abstract/2024/07000/vitamin_d_level_and_low_energy_fracture_risk_in.14.aspx
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Author Notes:Elio Assaf, Georges Nicolas, Fadi Hoyek, Georges Abi Fares, Jean Claude Lahoud, Rabih Hajj, Elisabeth Mohs, Franz-J. Dally, Svetlana Hetjens, Sascha Gravius, Ali Darwich

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520 |a The objective of this study is to document the rate of vitamin D deficiency and insufficiency among children with low-energy fractures and compare it to fracture-free control group. We included all children under 15 years presenting to the emergency department with low-energy fractures; controls were children without history of fractures from the outpatient department. Conventional X-ray and laboratory blood tests were performed. Vitamin D deficiency was defined as serum level ≤20 ng/ml, and the mean values were compared through two-sample t-tests. The influence of vitamin D on the fractures was defined using Chi-square test, significance with P-value < 0.05. The relationships between variables and odds of fracture occurrence were examined using logistic regression models. The final sample included 37 cases (30 males, 7 females, 7.4 ± 3.7 years) and 70 control individuals (42 males, 28 females, 7.8 ± 4.6 years) without significant differences regarding age, sex, and month of inclusion. Children with fractures had lower levels of vitamin D (21.87 ± 8.40 ng/ml vs. 25.89 ± 7.62 ng/ml) (P = 0.01). Vitamin D played a protective role against low-energy fractures (OR, 1.08; 95% CI, 1.01-1.14; P = 0.02), boys showed three times greater fracture risk than girls (OR, 3.00; 95% CI, 1.12-8.07; P = 0.03). Finally, vitamin D deficiency correlated with almost five times increased risk of pediatric low-energy fractures (OR, 4.63; 95% CI, 1.92-11.18; P = 0.001). This is the first MENA study establishing a relation between vitamin D deficiency and low-energy fractures among children and adolescents. The findings show the protective role of vitamin D on the pediatric bone and may help physicians preventing morbidity on children and costs on their families and the socioeconomic health system. 
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