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Long-term fracture risk among children with asthma: a population-based study
L Joseph Melton1, Ashok Patel, Sara J Achenbach
1Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Summary
Children with asthma face higher fracture risks, particularly males and oral corticosteroid users. These fractures often affect limbs, suggesting impaired skeletal development in pediatric asthma patients.
Area of Science:
- Pediatric asthma and bone health.
- Skeletal development and fracture risk.
Background:
- Limited population-based data exist on fracture outcomes for childhood-diagnosed asthma patients.
- Growing prevalence of childhood asthma necessitates understanding long-term skeletal health.
Purpose of the Study:
- To investigate fracture risk and outcomes in individuals diagnosed with asthma in childhood.
- To identify risk factors for fractures in this population.
Main Methods:
- Population-based retrospective cohort study of 279 Rochester, MN residents diagnosed with asthma before age 35.
- Fracture ascertainment through comprehensive medical record review.
- Age- and sex-matched controls used for comparison via stratified proportional hazards models.
Main Results:
- 107 asthma patients experienced 189 fractures over 6649 person-years (incidence rate: 2.8/100 person-years).
- No significant overall fracture risk increase compared to controls (HR, 1.3; 95% CI, 0.9-1.9).
- Males with asthma had higher risk of hand/finger fractures (2.6-fold). Independent predictors included male gender, oral corticosteroid, and anti-cholinergic use.
Conclusions:
- Oral corticosteroid therapy linked to limb fractures, not axial osteoporotic fractures.
- Findings suggest impaired biomechanically competent skeleton development in childhood asthma patients.
- Further research is needed to confirm the relationship between asthma, treatments, and skeletal development.