Association between bone mass and fractures in children: a prospective cohort study.
Association between bone mass and fractures in children: a prospective cohort study.
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DOI：
10.1359/jbmr.060601
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发表时间：
2006-09
期刊：
影响因子：
--
通讯作者：
Tobias JH
中科院分区：
文献类型：
--
作者：
Clark EM;Ness AR;Bishop NJ;Tobias JH
这是第一个关于儿童时期骨量和骨折风险之间关系的前瞻性队列研究。共有6213名9.9岁的儿童接受了为期24个月的随访。结果显示，在尺寸调整的BMC中，每SD降低，骨折风险增加89%。虽然以前的病例对照研究报告说，儿童骨折的风险是负相关的骨量，这还没有得到证实的前瞻性研究。此外，尚不清楚这种关联的骨量成分。我们进行了一项前瞻性队列研究，以检查9.9岁儿童DXA测量与随后2年骨折风险之间的关系。在9.9岁时获得的全身DXA扫描结果与英格兰西南部一个大型出生队列的儿童在随后2年内报告的骨折有关。DXA测量包括全身无头（TBLH）BMD、骨面积和BMC，以及肱骨分区域分析结果。分析根据年龄、性别、种族和社会地位进行调整。共有6213名儿童获得了完整的数据。9.9年时的BMD与随后的骨折风险之间呈弱负相关（每SD降低的OR = 1.12; 95%CI，1.02-1.25）。在分析骨折风险与体积BMD之间的关系时，骨折风险与经骨面积、身高和体重校正的BMC（OR = 1.89; 95%CI，1.18-3.04）和估计的肱骨体积BMD（OR = 1.29; 95%CI，1.14-1.45）呈负相关。骨折风险与TBLH和肱骨面积无关。然而，在分析骨折风险和相对于身体尺寸的骨尺寸之间的关系时，观察到骨折风险和经身高和体重校正的TBLH面积之间呈负相关（OR = 1.51; 95%CI，1.17-1.95）。儿童期骨折风险与骨密度有关，反映了骨密度决定因素（如皮质厚度）对骨骼脆性的影响。虽然骨骼大小本身与骨折风险无关，但我们发现骨折儿童的骨骼相对于其整体体型往往较小。
This is the first prospective cohort study of the association between bone mass and fracture risk in childhood. A total of 6213 children 9.9 years of age were followed for 24 months. Results showed an 89% increased risk of fracture per SD decrease in size-adjusted BMC. Although previous case-control studies have reported that fracture risk in childhood is inversely related to bone mass, this has not been confirmed in prospective studies. Additionally, it remains unclear which constituent(s) of bone mass underlie this association. We carried out a prospective cohort study to examine the relationship between DXA measures in children 9.9 years of age and risk of fracture over the following 2 years. Total body DXA scan results obtained at 9.9 years of age were linked to reported fractures over the following 2 years in children from a large birth cohort in southwest England. DXA measures consisted of total body less head (TBLH) BMD, bone area, and BMC, and results of subregional analysis of the humerus. Analyses were adjusted for age, sex, ethnicity, and social position. Complete data were available on 6213 children. There was a weak inverse relationship between BMD at 9.9 years and subsequent fracture risk (OR per SD decrease = 1.12; 95% CI, 1.02–1.25). In analyses examining the relationship between fracture risk and volumetric BMD, fracture risk was inversely related to BMC adjusted for bone area, height, and weight (OR = 1.89; 95% CI, 1.18–3.04) and to estimated volumetric BMD of the humerus (OR = 1.29; 95% CI, 1.14–1.45). Fracture risk was unrelated to both TBLH and humeral bone area. However, in analyses of the relationship between fracture risk and bone size relative to body size, an inverse association was observed between fracture risk and TBLH area adjusted for height and weight (OR = 1.51; 95% CI, 1.17–1.95). Fracture risk in childhood is related to volumetric BMD, reflecting an influence of determinants of volumetric BMD such as cortical thickness on skeletal fragility. Although bone size per se was not related to fracture risk, we found that children who fracture tend to have a smaller skeleton relative to their overall body size.
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影响因子：
4.6
作者：
Suuriniemi, M;Mahonen, A;Cheng, SL
通讯作者：
Cheng, SL
DOI：
10.1001/archpedi.1984.02140440053013
发表时间：
1984-01-01
影响因子：
--
作者：
CHAN, GM;HESS, M;BOOK, LS
通讯作者：
BOOK, LS
影响因子：
1.7
作者：
COOK, SD;HARDING, AF;THOMAS, KA
通讯作者：
THOMAS, KA
影响因子：
6.2
作者：
Goulding, A;Cannan, R;Lewis-Barned, NJ
通讯作者：
Lewis-Barned, NJ
影响因子：
--
作者：
Lyons, RA;Delahunty, AM;Nash, P
通讯作者：
Nash, P