Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jul;32(7):1287-1300.
doi: 10.1007/s00198-020-05814-1. Epub 2021 Mar 11.

Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis

G Yang  1 , W Y W Lee  1   2 , A L H Hung  1 , M F Tang  3 , X Li  4 , A P S Kong  2   5 , T F Leung  3   6 , P S H Yung  7 , K K W To  8   9 , J C Y Cheng  1 , T P Lam  10
Affiliations
Meta-Analysis

Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis

G Yang et al. Osteoporos Int. 2021 Jul.

Abstract

The association between the risk of fractures and suboptimal vitamin D (Vit-D) status remains controversial in children. This meta-analysis suggested that serum 25(OH)Vit-D levels were lower in pediatric cases with fractures. 25-hydroxyvitamin D (25(OH)Vit-D) levels less than 50 nmol/L were associated with increased fracture risk in children.

Introduction: This study aimed to assess the association between serum 25(OH)Vit-D and the risk of fractures in children, and to explore the sources of heterogeneity and investigate their impact on results.

Methods: Systematic review and meta-analysis were conducted for observational studies comparing serum 25(OH)Vit-D levels between fracture and non-fracture pediatric cases. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results: Analysis on 17 case-control and 6 cross-sectional studies (2929 fracture cases and 5000 controls) suggested that 25(OH)Vit-D was lower in fracture cases than in controls (pooled mean difference (MD) = - 3.51 nmol/L; 95% confidence interval (CI): - 5.60 to - 1.42) with a heterogeneity (I2) of 73.9%. The sensitivity analysis which merged the case-control studies that had a NOS score ≥ 4 showed a pooled MD of - 4.35 nmol/L (95% CI: - 6.64 to - 2.06) with a heterogeneity (I2) of 35.9%. Pooled odds ratio of fracture in subjects with 25(OH)Vit-D ≤ 50 nmol/L compared to subjects with 25(OH)Vit-D > 50 nmol/L was 1.29 (95% CI: 1.10 to 1.53; I2 < 1%).

Conclusion: This study indicated that serum 25(OH)Vit-D levels were lower in pediatric patients with fractures. 25(OH)Vit-D ≤ 50 nmol/L was associated with increased fracture risk in children.

Keywords: 25(OH)Vit-D; Pediatric fracture; Seasonal variation; Vitamin D deficiency.

PubMed Disclaimer

References

    1. Jones IE, Williams SM, Dow N, Goulding A (2002) How many children remain fracture-free during growth? A longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study. Osteoporos Int 13(12):990–995. https://doi.org/10.1007/s001980200137 - DOI - PubMed
    1. Khosla S, Melton LJ 3rd, Dekutoski MB, Achenbach SJ, Oberg AL, Riggs BL (2003) Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA 290(11):1479–1485. https://doi.org/10.1001/jama.290.11.1479 - DOI - PubMed
    1. Clark EM, Ness AR, Tobias JH (2008) Bone fragility contributes to the risk of fracture in children, even after moderate and severe trauma. J Bone Miner Res 23(2):173–179. https://doi.org/10.1359/jbmr.071010 - DOI - PubMed - PMC
    1. Buttazzoni C, Rosengren BE, Tveit M, Landin L, Nilsson JA, Karlsson MK (2013) Does a childhood fracture predict low bone mass in young adulthood? A 27-year prospective controlled study. J Bone Miner Res 28(2):351–359. https://doi.org/10.1002/jbmr.1743 - DOI - PubMed
    1. Amin S, Melton LJ 3rd, Achenbach SJ, Atkinson EJ, Dekutoski MB, Kirmani S, Fischer PR, Khosla S (2013) A distal forearm fracture in childhood is associated with an increased risk for future fragility fractures in adult men, but not women. J Bone Miner Res 28(8):1751–1759. https://doi.org/10.1002/jbmr.1914 - DOI - PubMed - PMC

LinkOut - more resources