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Prevalence of vitamin D insufficiency in Swiss teenagers with appendicular fractures: a prospective study of 100 cases

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Background

The significance of subclinical vitamin D deficiency in the pathogenesis of fractures in children and adolescents currently remains unclear.

Objective

We aimed to determine the prevalence of vitamin D insufficiency and its effect on bone mineral density (BMD) and bone mineral content (BMC) values in a collective of Swiss Caucasian children with a first episode of appendicular fracture.

Design and methods

One hundred teenagers with a first episode of appendicular fracture [50 upper limb fractures (group 1) and 50 lower limb fractures (group 2)] and 50 healthy controls (group 3) were recruited into a cross-sectional study. The BMC and BMD values were measured by dual-energy X-ray absorptiometry, and serum 25 hydroxyvitamin D [25(OH)D] was assessed by electrochemiluminescence immunoassays.

Results

From the 100 injured teenagers in the study, 12 % had deficient vitamin D levels (<20 ng/mL; <50 nmol/L) and 36 % had insufficient levels (≥20 <30 ng/mL; ≥50 <78 nmol/L), whereas 6 and 34 % of healthy controls were, respectively, vitamin D deficient and insufficient. There were no significant differences for serum 25(OH)D levels, L2–L4 BMD Z-score, and L2–L4 BMC Z-score variables (p = 0.216) between the three groups nor for the calcaneal BMD Z-score variables (p = 0.278) between healthy controls and lower limb fracture victims. Investigations on the influences of serum 25(OH)D on BMD and BMC showed no correlation between serum 25(OH)D and L2–L4 BMD Z-scores (r = −0.15; p = 0.135), whereas low but significant inverse correlations were, surprisingly, detected between serum 25(OH)D and calcaneal BMD Z-scores (r = −0.21; p = 0.034) and between serum 25(OH)D and L2–L4 BMC Z-scores (r = −0.22; p = 0.029).

Conclusions

A significant proportion of Swiss Caucasian teenagers were vitamin D insufficient, independent of limb fracture status, in our study. However, this study failed to show an influence of low vitamin D status on BMD and/or BMC of the lumbar spine and heel.

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Acknowledgments

This study was supported by grants from the Swiss National Science Foundation (SNSF #405340-104611).

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Authors and Affiliations

  1. Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Children’s Hospitals and University of Geneva Faculty of Medicine, 6 Rue Willy-Donzé, 1211, Geneva 14, Switzerland

    Dimitri Ceroni, Rebecca Anderson de la Llana, Xavier Martin, Léopold Lamah, Geraldo De Coulon, Katia Turcot & Victor Dubois-Ferrière

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  1. Dimitri Ceroni
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  2. Rebecca Anderson de la Llana
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Correspondence to Dimitri Ceroni.

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Ceroni, D., Anderson de la Llana, R., Martin, X. et al. Prevalence of vitamin D insufficiency in Swiss teenagers with appendicular fractures: a prospective study of 100 cases. J Child Orthop 6, 497–503 (2012). https://doi.org/10.1007/s11832-012-0446-7

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  • DOI: https://doi.org/10.1007/s11832-012-0446-7

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