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Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study
Laura N Anderson1,2, Sze Wing Heong3, Yang Chen4
1Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Insights
Vitamin D supplementation, not serum levels or milk intake, significantly reduced fracture risk in young children. This finding highlights the importance of vitamin D supplements for bone health in pediatric populations.
Area of Science:
- Pediatrics
- Nutritional Science
- Orthopedics
Background:
- Pediatric fractures are a significant concern.
- Vitamin D is crucial for bone health.
- The role of vitamin D intake, serum levels, and supplementation in pediatric fracture risk requires further elucidation.
Purpose of the Study:
- To investigate the association between vitamin D intake, serum 25-hydroxyvitamin D levels, and fracture risk in children under 6 years of age.
- To determine if vitamin D supplementation impacts fracture risk in this age group.
Main Methods:
- A case-control study was conducted in Toronto, Canada.
- Cases were children with fractures, and controls were healthy children matched for age, sex, height, and season.
- Fracture risk was analyzed using conditional logistic regression, adjusting for multiple covariates including vitamin D status and lifestyle factors.
Main Results:
- Serum 25-hydroxyvitamin D levels and cow's milk intake were not significantly associated with fracture risk.
- Child use of vitamin D supplements showed a statistically significant association with decreased odds of fracture (aOR = 0.42, 95% CI: 0.25, 0.69).
Conclusions:
- Vitamin D supplementation, rather than serum vitamin D concentration or milk intake, was associated with reduced fracture risk in healthy young children.
- These findings suggest that vitamin D supplementation may be a key factor in preventing fractures in pediatric populations.
Abstract:
The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009-April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (<2 cups/day vs. 2 cups/day: aOR = 0.95 (95% CI: 0.60, 1.52); >2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25, 0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children.
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