The impact of childhood obesity on different fracture sites

The prevalence of childhood obesity has been increasing worldwide, garnering increasing public attention due to various complications and long-term effects. Many researchers have indicated that obese children experienced higher fracture risk compared with nonobese children. However, the findings from different researchers reported a controversial result and few of them paid attention to the differences in BMI Z-score and obesity between different fracture sites, which would be quite useful since these can guide obese children in protecting specific regions. This study comprised 17,942 hospitalized children diagnosed with fractures and 3219 healthy children who came for physical examination and had not been diagnosed with any illness. Data on age, gender, fracture seasons, fracture sites, height, weight, total cholesterol, triacylglycerol, and high-density lipoprotein were collected. One-way ANOVA, t-test, Chi-square test, propensity score matching, and logistic regression models were used in statistical analysis. Children with lower limb fractures exhibited the highest BMI Z-score (0.58 ± 1.74), followed by those with upper limb fractures (0.50 ± 1.52), axial fractures (0.31 ± 1.56), and head fractures (-0.02 ± 1.52). In terms of obesity, children with lower limb fractures exhibited the highest obesity rate (20.20%), whereas those with upper limb fractures (15.61%) and axial fractures (14.96%) displayed comparable obesity rates. Children with head fractures had the lowest obesity rate (8.42%). Moreover, BMI Z-score (2.43 ± 1.22vs0.15 ± 1.43, P < 0.001), obesity (62.97%vs8.61%, P < 0.001) and dyslipidemia (31.22%vs24.67%, P < 0.001) were statistically significant difference between the fracture and healthy groups. The logistic regression models showed that BMI Z-score was associated with an increased risk of fracture (P < 0.001, OR = 4.89, 95%CI: 4.53-5.27). This study suggests that children with lower limb fractures exhibited the highest BMI Z-score and obesity rate, while those with head fractures had the lowest BMI Z-score and obesity rate. When compared with the healthy group, fracture children had higher BMI Z-score, obesity, and dyslipidemia rates. In addition, BMI Z-score was associated with an increased risk of fractures.