Analysis of Bone Health in African American Children with Forearm Fractures

描述（由申请人提供）：儿童骨折是常见的，导致大量的费用和发病率，并且发病率似乎在增加。最近的研究表明，在其他方面健康的儿童中，骨折风险升高是骨矿化降低的一个功能。由于大多数骨矿化发生在成年之前，儿童时期的骨骼健康状况不佳也会对成人的骨骼健康产生负面影响，并可能增加与骨质疏松症相关的成人骨折的风险。早期识别骨骼健康状况不佳的儿童可能会使早期干预具有重要的长期效益。特别是非洲裔美国儿童，由于环境和遗传因素，骨骼健康状况不佳的风险可能更高。因此，本病例对照研究的总体目标是比较有外伤性骨折和没有外伤性骨折的城市非洲裔美国儿童的骨骼健康状况，以评估患有前臂骨折的非洲裔美国儿童比无骨折的对照组更容易出现骨骼健康缺陷的假设。具体目的1：确定非洲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系。假设1：患者的体重指数明显高于对照组，饮食中钙/维生素D的摄入量明显低于对照组，日照时间明显少于对照组。具体目标2：确定病例和对照组中维生素D缺乏症和骨密度（BMD）下降的患病率。假设2：病例中维生素D缺乏症的患病率明显高于对照组，骨密度明显低于对照组。具体目的3：研究非洲裔美国儿童前臂骨折与F等位基因维生素D受体基因多态性之间的关系。假设3：病例的F等位基因SNP明显高于对照组。这一建议是独特的，在其调查骨骼健康和儿童骨折之间的关系，通过一个系统的评估骨骼健康在弱势群体。进一步阐明高危儿童骨骼健康缺陷与骨折之间的关系，将有助于进行有针对性的干预，从而降低儿童后期和成年期的骨折发生率。此外，本研究的结果可以通过筛选和扩展伤害预防策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.