title: Prevalence of Fracture in Healthy Iranian Children Aged 9-18 Years and Associated Risk Factors; A Population Based Study.
abstract: OBJECTIVE
  To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.
  
  
  METHODS
  In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9-18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured.
  
  
  RESULTS
  We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03,p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4,p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188,p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003,p=0.039).
  
  
  CONCLUSIONS
  Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures.
authors.affiliation: Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Jeddi
authors.affiliation: Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.affiliation: Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Kharmandar
authors.affiliation: Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Ranjbar Omrani
authors.affiliation: Shiraz Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bakhshayeshkaram
keywords: Children; Fracture; Long bone; Risk Factors; Trauma