Bone Health in Pediatric Fracture Patients: A DEXA Study  

作　　者：Barbara Minkowitz Jennifer Ristic Leah Nadel Meghan McDermott Violet Wallerstein Eileen Poletick Barbara Minkowitz;Jennifer Ristic;Leah Nadel;Meghan McDermott;Violet Wallerstein;Eileen Poletick(Department of Orthopedics, Morristown Medical Center, Goryeb Children’s Hospital, Atlantic Health Systems, Morristown, NJ, USA)

机构地区：[1]Department of Orthopedics, Morristown Medical Center, Goryeb Children’s Hospital, Atlantic Health Systems, Morristown, NJ, USA

出　　处：《Open Journal of Orthopedics》2022年第2期57-65,共9页矫形学期刊（英文）

摘　　要：Vitamin D deficiency is widespread in children and is associated with increased fracture severity. Previous studies have shown mixed results on the impact of vitamin D supplementation on bone health parameters measured on dual-energy x-ray absorptiometry (DEXA) scan. This is the first longitudinal DEXA study in a pediatric fracture population. Pediatric fracture patients with vitamin D levels below 20 ng/mL were counseled to take vitamin D and calcium per a serum-based protocol. Patients underwent baseline DEXA within the initial 12 weeks post fracture and had follow-up scans at 6 and 12 months. 48 patients were enrolled, 32 patients completed two DEXA scans, and 19 completed three DEXA scans. There was a significant increase in lumbar spine BMC, TBLH BMD, and TBLH BMC between DEXA 1 and 2 (p 0.001). A positive trend in DEXA parameters is suggested between DEXA 1 and DEXA 3. Height adjusted z-scores (HAZ) were calculated which showed no statistical significance, p-values > 0.05. In this group, there are no significant changes in TBLH, BMC or BMD z-scores one year after fracturing despite vitamin D and calcium supplementation. This suggests that children returning to collision sports may be at continued risk for refracture and future studies are needed.Vitamin D deficiency is widespread in children and is associated with increased fracture severity. Previous studies have shown mixed results on the impact of vitamin D supplementation on bone health parameters measured on dual-energy x-ray absorptiometry (DEXA) scan. This is the first longitudinal DEXA study in a pediatric fracture population. Pediatric fracture patients with vitamin D levels below 20 ng/mL were counseled to take vitamin D and calcium per a serum-based protocol. Patients underwent baseline DEXA within the initial 12 weeks post fracture and had follow-up scans at 6 and 12 months. 48 patients were enrolled, 32 patients completed two DEXA scans, and 19 completed three DEXA scans. There was a significant increase in lumbar spine BMC, TBLH BMD, and TBLH BMC between DEXA 1 and 2 (p 0.001). A positive trend in DEXA parameters is suggested between DEXA 1 and DEXA 3. Height adjusted z-scores (HAZ) were calculated which showed no statistical significance, p-values > 0.05. In this group, there are no significant changes in TBLH, BMC or BMD z-scores one year after fracturing despite vitamin D and calcium supplementation. This suggests that children returning to collision sports may be at continued risk for refracture and future studies are needed.

关 键 词：Bone Health PEDIATRIC FRACTURE Vitamin D DEXA OSTEOPOROSIS OSTEOPENIA Vitamin D Deficiency 

分 类 号：R58[医药卫生—内分泌]