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The association between first fractures sustained during childhood and adulthood and bone measures in young adulthood


Yang, Y and Wu, F and Antony, B and Pan, F and Winzenberg, T and Jones, G, The association between first fractures sustained during childhood and adulthood and bone measures in young adulthood, Journal of Pediatrics, 212 pp. 188-194. ISSN 0022-3476 (2019) [Refereed Article]

Copyright Statement

Copyright 2019 Elsevier Inc.

DOI: doi:10.1016/j.jpeds.2019.05.031


Objective: To describe the association between fractures sustained at different stages of growth and bone measures in early adulthood.

Study Design: Participants (n = 201) in southern Tasmania were at birth at a higher risk of sudden infant death syndrome; they were followed to age 25. Outcomes were areal bone mineral density at the spine, hip, and total body (by dual-energy x-ray absorptiometry) and trabecular and cortical bone measures at the radius and tibia (by high-resolution peripheral quantitative computed tomography). Fractures were self-reported and confirmed by radiographs at 8, 16, and 25 years of age. Multivariable linear regression was used to analyze the association of the occurrence of prepubertal (<9 years of age), pubertal (9-16 years of age), and postpubertal (17-25 years of age) fractures with all bone measures.

Results: Over 25 years, 99 participants had at least 1 fracture. For high-resolution peripheral quantitative computed tomography measures at age 25, prepubertal fractures were negatively associated with cortical and trabecular volumetric bone mineral density and most microarchitecture measures at both the tibia and radius. Prepubertal fractures had a significant association with smaller increase of areal bone mineral density from age 8 to 16 years and at 25 years of age compared with participants with no fractures. Pubertal fractures had no association with any bone measures and postpubertal fractures were only associated with a lower trabecular number at the tibia.

Conclusions: Prepubertal fractures are negatively associated with areal bone mineral density increases during growth and high-resolution peripheral quantitative computed tomography bone measures in young adulthood. There is little evidence that fractures occurring from age 8 years onward with bone measures in young adulthood, implying that prepubertal fractures may be associated with bone deficits later in life.

Item Details

Item Type:Refereed Article
Keywords:bone QCT/micro CT, cortical porosity, peak bone mass, puberty
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Yang, Y (Miss Yi Yang)
UTAS Author:Wu, F (Dr Feitong Wu)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Pan, F (Dr Feng Pan)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:133793
Year Published:2019
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-07-10
Last Modified:2020-04-08

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