Analysis of Bone Health in African American Children with Forearm Fractures

描述(由申请人提供)：儿童骨折很常见，导致巨大的费用和发病率，而且发病率似乎在增加。最近的研究表明，在其他健康的儿童中，骨折风险的增加是骨矿化降低的一个函数。由于大多数骨矿化发生在成年期之前，儿童时期骨健康不良也会对成人骨健康产生负面影响，并可能增加与骨质疏松相关的成人骨折的风险。及早发现骨健康状况不佳的儿童可能会使早期干预成为可能，并带来重要的长期好处。特别是非裔美国儿童，由于环境和遗传因素，他们骨骼健康状况不佳的风险可能更高。因此，这项病例对照研究的总体目标是比较有和没有创伤性骨折的城市非裔美国儿童的骨健康状况，以评估前臂骨折的非裔美国儿童比没有骨折的非裔美国儿童更有可能缺乏骨健康的假设。具体目标1：确定非裔美国儿童前臂骨折与骨骼健康的环境预测因素之间的关联。假设1：患者的体重指数显著高于对照组，膳食中钙/维生素D的摄入量显著低于对照组，阳光暴露量也显著低于对照组。具体目标2：确定患者和对照组中维生素D缺乏和骨密度降低的患病率。假设2：患者的维生素D缺乏症患病率显著高于对照组，而骨密度显著低于对照组。具体目的3：探讨非裔美国儿童前臂骨折与F等位基因维生素D受体基因多态性的关系。假设3：病例的F等位基因SNP显著高于对照组。这项建议在通过对脆弱人群的骨健康进行系统评估来研究骨健康与儿童骨折之间的关系方面是独一无二的。进一步阐明高危儿童的骨健康缺陷与骨折之间的联系将使有针对性的干预成为可能，这可能会降低儿童后期和成年后的骨折发生率。此外，这项研究的结果可以通过筛查和扩大伤害预防战略来促进有效的预防，以识别导致风险的潜在医疗条件。

Description (provided by applicant): Childhood fractures are common, result in substantial costs and morbidity and appear to be increasing in incidence. Recent studies suggest that elevated fracture risk in otherwise healthy children is a function of lower bone mineralization. Because the majority of bone mineralization occurs before adulthood, poor bone health in childhood also negatively impacts adult bone health and may increase the risk of adult fractures associated with osteoporosis. Early identification of children with poor bone health may allow early intervention with important long term benefits. African American children, in particular, may be at higher risk of poor bone health due to both environmental and genetic factors. The overall objective of this case-control study is therefore to compare bone health in urban African American children with and without traumatic fractures to evaluate the hypothesis that African American children with forearm fractures are more likely to have deficient bone health than fracture-free controls. Specific Aim 1: Determine the association between forearm fracture in African American children and environmental predictors of bone health. Hypothesis 1: Cases will have significantly higher body mass index, significantly lower dietary intake of calcium/vitamin D and significantly less sun exposure than controls. Specific Aim 2: Determine the prevalence of vitamin D deficiency and decreased bone density (BMD) among cases and controls. Hypothesis 2: Cases will have a significantly higher prevalence of vitamin D deficiency and a significantly lower BMD than controls. Specific Aim 3: Investigate the association between forearm fracture in African American children and the F allele vitamin D receptor gene polymorphism. Hypothesis 3: Cases will have significantly more prevalent F allele SNP than controls. This proposal is unique in its investigation of the relationship between bone health and childhood fractures through a systematic evaluation of bone health in a vulnerable population. Further elucidating the association between bone health deficits and fractures in at-risk children would enable targeted intervention, which may decrease fracture rates, both in later childhood and in adulthood. Furthermore, the results of this research could promote effective prevention through screening and the expansion of injury prevention strategies to recognize underlying medical conditions contributing to risk.