title: Bone mineral density and vitamin D status among African American children with forearm fractures.
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.
authors.affiliation: Children's National Medical Center, Division of Emergency Medicine, 111 Michigan Ave NW, Washington, DC 20010, USA. lryan@childrensnational.org
authors.forename: Leticia Manning
authors.initials: LM
authors.lastname: Ryan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Teach
authors.forename: Steven A
authors.initials: SA
authors.lastname: Singer
authors.forename: Rachel
authors.initials: R
authors.lastname: Wood
authors.forename: Robert
authors.initials: R
authors.lastname: Freishtat
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Wright
authors.forename: Robert
authors.initials: R
authors.lastname: McCarter
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; D002136:Calcium, Dietary / Q000008:administration & dosage; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D011885:Radius Fractures / Q000097:blood / Q000208:ethnology* / Q000473:pathology; D014458:Ulna Fractures / Q000097:blood / Q000208:ethnology* / Q000473:pathology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; C104450:25-hydroxyvitamin D