title: Prevalence of vitamin D insufficiency in African American children with forearm fractures: a preliminary study.
abstract: OBJECTIVE
  Forearm fractures account for a significant proportion of childhood injuries and seem to be increasing in incidence. Poor vitamin D status increases overall fracture risk in infants with rickets and adults with osteoporosis. Children with vitamin D insufficiency (serum 25-hydroxy vitamin D level <20 ng/mL) have decreased bone mineral density (BMD) compared with children having normal vitamin D status. The relationship between vitamin D status and childhood forearm fracture has not been investigated.
  
  
  METHODS
  This prospective study enrolled African American children, aged 5 to 9 years, with a forearm fracture. Bone health evaluation included measurement of serum 25-hydroxy vitamin D level and BMD by dual energy x-ray absorptiometry scan. Univariable analyses were used to test the associations between fracture status and the independent variables, serum vitamin D level and BMD.
  
  
  RESULTS
  Vitamin D levels were available for 17 cases. The mean (+/-SD) 25-hydroxy vitamin D level was 20.1 (+/-7.3) ng/mL with a range of 10 to 38 ng/mL. The mean of this group was at the cut point for vitamin D insufficiency. Ten cases (59%) were vitamin D insufficient. Dual energy x-ray absorptiometry scan results for these patients were consistent with normal bony mineralization for age.
  
  
  CONCLUSIONS
  A significant proportion of African American children with fractures in our study have vitamin D insufficiency. Analysis of serum 25-hydroxy vitamin D levels and BMD in additional cases and controls will determine the significance of these findings.
  
  
  CONCLUSIONS
  Vitamin D insufficiency may play a previously unrecognized role in childhood fractures. Strong consideration should be given to routine vitamin D testing in African American children with forearm fractures.
authors.affiliation: Division of Emergency Medicine, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 20010, USA. lryan@cnmc.org
authors.forename: Leticia Manning
authors.initials: LM
authors.lastname: Ryan
authors.forename: Cinzia
authors.initials: C
authors.lastname: Brandoli
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Freishtat
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Wright
authors.forename: Laura
authors.initials: L
authors.lastname: Tosi
authors.forename: James M
authors.initials: JM
authors.lastname: Chamberlain
mesh_terms: D015502:Absorptiometry, Photon; D001741:Black or African American; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011885:Radius Fractures / Q000209:etiology*; D014458:Ulna Fractures / Q000209:etiology*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications* / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D