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An epidemiological evaluation of fractures and its determinants among Lebanese schoolchildren: a cross-sectional study

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Abstract

Summary

The purpose of this study is to establish the prevalence and determinants of fractures among 974 Lebanese schoolchildren aged 8–18. Fractures might be less common in the Lebanese pediatric population compared to western populations. Male gender and high SES are independent risk factors for fractures, while 25(OH)D and BMI have no impact.

Purpose

To establish the prevalence of fractures among Lebanese schoolchildren and its relationship with age, gender, BMI, 25 hydroxyvitamin D (25(OH)D) levels, and socioeconomic status (SES).

Methods

In this cross-sectional study, 974 Lebanese schoolchildren aged 8–18 years old, mean age 13.37 ± 2.92 (508 boys and 466 girls), were recruited from 10 schools with different SES. For each participant, a questionnaire was used to collect data regarding history of fractures. Serum 25(OH)D was also measured.

Results

The prevalence of Lebanese children sustaining ≥ 1 fracture was 16.9% and was higher in boys compared to girls (22.2% vs 11.1%, p < 0.0001). A 71.3% of fractures were localized in the upper limbs and 20% of participants had at least one displaced fracture. Children who sustained a fracture had a non-significant higher BMI compared to those without (p = 0.096). The percentage of children with fractures was higher in children from high SES compared to those from middle and low SES (respectively 23.3% vs. 16.3% and 13.8%, p < 0.0001). Fractures occurred at a younger age in girls compared to boys, but this difference was non-significant (p = 0.13). 25(OH)D levels were significantly higher in children with fractures compared to those without (p = 0.017). Finally, female gender was protective against upper limb fractures (p = 0.009). In a logistic regression analysis, male gender and high SES were independently associated with fractures, while BMI and 25(OH)D were not.

Conclusion

Our study demonstrates that the prevalence of fractures in the Lebanese pediatric population might be lower than western populations. It also confirms that male gender and high SES are independent risk factors for fractures, while 25(OH)D and BMI were not independently associated with fracture risk.

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Abbreviations

BMI:

Body Mass Index (BMI),

25(OH)D:

25 hydroxyvitamin D

SES:

socioeconomic status.

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Funding

Conseil de la recherche de l’Université Saint-Joseph” (FM249), Beirut, Lebanon and Pharmaline Laboratories Lebanon.

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Authors and Affiliations

  1. Division of Endocrinology, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon

    Nada Younes, Marie-Ange El Hajj, Aren Joe Bizdikian & Marie-Hélène Gannagé-Yared

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  1. Nada Younes
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  2. Marie-Ange El Hajj
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  3. Aren Joe Bizdikian
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  4. Marie-Hélène Gannagé-Yared
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Contributions

NY and MA performed the data collection and participate to the writing of the manuscript. AJB performed the statistical analysis and interpreted the results. MHG designed the study, got the funding, and participate to the writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Marie-Hélène Gannagé-Yared.

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Conflict of interest

None.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of our hospital (Reference number CEHDF449) and Informed consent was signed by the children’s parents.

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Younes, N., El Hajj, MA., Bizdikian, A.J. et al. An epidemiological evaluation of fractures and its determinants among Lebanese schoolchildren: a cross-sectional study. Arch Osteoporos 14, 9 (2019). https://doi.org/10.1007/s11657-019-0559-4

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