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超重或肥胖青少年维生素D缺乏与骨折之间的关系

Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity.

作者信息

Segal David, Ziv Adi, Meisman Andrea, Fry Jordan, Altaye Mekibib, Gordon Catherine M

机构信息

Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Division of Orthopaedic Surgery, Meir Medical Center and Tel Aviv University, Kfar Saba, Israel.

出版信息

Clin Pediatr (Phila). 2023 Feb;62(2):107-114. doi: 10.1177/00099228221112461. Epub 2022 Jul 26.

Abstract

Adolescents with overweight/obesity are at risk for vitamin D insufficiency and deficiency. Both overweight/obesity and vitamin D insufficiency/deficiency may predispose to fractures. We enrolled 103 participants (53.3% females, 15.9 ± 2.2 years) in a retrospective case-control study to determine whether an association exists between fractures and a low 25-hydroxyvitamin D (25[OH]D) among adolescents whose body mass index (BMI) ≥ 85 percentile. Cases (n = 28) sustaining a low/medium impact fracture were matched to controls (n = 75) without a fracture history. A conditional-logistic regression analysis addressing the common vitamin D insufficiency/deficiency cutoffs was used. Overweight, obesity, and significant obesity rates were 10.7%, 53.4%, and 35.9%, respectively. Mean (±SD) 25(OH)D was 16.5 ± 6.4 ng/mL. In all, 25(OH)D insufficiency rates (level <20 ng/mL) were 70.5%. Matched cases and controls had similar 25(OH)D insufficiency/deficiency rates ( > .05). Controlling for race and seasonality showed no association between fractures and 25(OH)D insufficiency/deficiency ( > .05). These data suggest that fractures are not associated with low 25(OH)D levels among adolescents whose BMI ≥ 85th percentile.

摘要

超重/肥胖的青少年存在维生素D不足和缺乏的风险。超重/肥胖以及维生素D不足/缺乏都可能导致骨折。我们纳入了103名参与者(53.3%为女性,年龄15.9±2.2岁)进行一项回顾性病例对照研究,以确定在体重指数(BMI)≥第85百分位数的青少年中,骨折与低25-羟基维生素D(25[OH]D)之间是否存在关联。发生低/中度冲击性骨折的病例(n = 28)与无骨折史的对照(n = 75)进行匹配。采用条件逻辑回归分析来处理常见的维生素D不足/缺乏临界值。超重、肥胖和重度肥胖率分别为10.7%、53.4%和35.9%。25(OH)D的平均(±标准差)水平为16.5±6.4 ng/mL。总体而言,25(OH)D不足率(水平<20 ng/mL)为70.5%。匹配的病例和对照具有相似的25(OH)D不足/缺乏率(P>.05)。控制种族和季节性因素后,骨折与25(OH)D不足/缺乏之间无关联(P>.05)。这些数据表明,在BMI≥第85百分位数的青少年中,骨折与低25(OH)D水平无关。

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