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Published on: January 29, 2018
Childhood fractures do not predict future fractures: results from the European Prospective Osteoporosis Study
Stephen R Pye1, Jon Tobias, Alan J Silman
1ARC Epidemiology Unit, The University of Manchester, Manchester, United Kingdom.
Insights
A history of childhood fractures does not predict future limb fractures or vertebral deformities in adults. This study found no increased risk for osteoporosis-related fractures later in life following childhood bone injuries.
Area of Science:
- Orthopedics
- Gerontology
- Epidemiology
Background:
- Childhood fractures are common, but their long-term implications for adult bone health, including osteoporosis and fracture risk, remain unclear.
- Understanding the link between early-life bone injuries and later-life skeletal fragility is crucial for public health and preventative strategies.
Purpose of the Study:
- To investigate the predictive value of childhood fractures (ages 8-18) on the risk of fractures in later life (age 50+).
- To determine the association between reported childhood fractures and prevalent vertebral deformities in adulthood.
Main Methods:
- A cohort of 13,387 men and women aged 50+ from the European Prospective Osteoporosis Study (EPOS) was analyzed.
- Data on childhood fractures and age of first fracture were collected via questionnaires; vertebral deformities were assessed using spine radiographs.
- Cox proportional hazards models and logistic regression analyzed the risk of future limb fractures and association with vertebral deformities, respectively. Bone mineral density (BMD) was measured in a subsample.
Main Results:
- A history of any childhood fracture or forearm fracture did not correlate with an increased risk of future limb fractures or prevalent vertebral deformity in either sex.
- Bone mineral density (BMD) measurements showed no significant differences between subjects with and without a reported childhood fracture.
- The study included 6,451 men and 6,936 women with a mean follow-up of 3 years.
Conclusions:
- Self-reported childhood fractures are not associated with an increased risk of future limb fractures or vertebral deformities in men and women aged 50 and older.
- Childhood fracture history does not appear to be a reliable predictor of osteoporosis or fracture risk in later life.
- Further research may explore other childhood factors influencing adult bone health.
Abstract:
Childhood fractures are common. Their clinical relevance to osteoporosis and fractures in later life is unclear. The aim of this study was to determine the predictive risk of childhood fracture on the risk of fracture in later life. Men and women >or=50 yr of age were recruited from population registers for participation in the European Prospective Osteoporosis Study (EPOS). Subjects completed an interviewer administered questionnaire that included questions about previous fractures and the age at which the first of these fractures occurred. Lateral spine radiographs were performed to ascertain prevalent vertebral deformities. Subjects were followed prospectively by postal questionnaire to determine the occurrence of clinical fractures. A subsample of subjects had BMD measurements performed. Cox proportional hazards model was used to determine the predictive risk of childhood fracture between the ages of 8 and 18 yr on the risk of future limb fracture and logistic regression was used to determine the association between reported childhood fractures and prevalent vertebral deformity. A total of 6451 men (mean age, 63.8 yr) and 6936 women (mean age, 63.1 yr) were included in the analysis. Mean follow-up time was 3 yr. Of these, 574 (8.9%) men and 313 (4.5%) women reported a first fracture (any site) between the ages of 8 and 18 yr. A recalled history of any childhood fracture or forearm fracture was not associated with an increased risk of future limb fracture or prevalent vertebral deformity in either men or women. Among the 4807 subjects who had DXA measurements, there was no difference in bone mass among those subjects who had reported a childhood fracture and those who did not. Our data suggest that self-reported previous childhood fracture is not associated with an increased risk of future fracture in men or women.
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