Prevalence of vitamin D insufficiency in African American children with forearm fractures: a preliminary study.
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.
Ryan
Leticia Manning
LM
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
Brandoli
Cinzia
C
Freishtat
Robert J
RJ
Wright
Joseph L
JL
Tosi
Laura
L
Chamberlain
James M
JM
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
D014807:Vitamin D; C104450:25-hydroxyvitamin D