Incidence and determinants of fracture risk in 8,348 Mongolian schoolchildren: secondary analysis of data from a randomised controlled trial
Abstract
ABSTRACT:
Background: Data on incidence and determinants of fracture risk among children living in non-Western settings are limited. The predictive value of radial quantitative ultrasound (QUS) for fracture risk in children remains uncertain.
Methods: We conducted secondary analyses of data from 8,348 schoolchildren aged 6-13 years living in Ulaanbaatar, Mongolia, who participated in a population-based randomised controlled trial of vitamin D supplementation with 3-year follow-up. Radial speed-of-sound (SOS) was measured at baseline in a subset of 1,456 children. Multivariable Poisson regression was used to estimate fracture incidence, identify determinants of fracture risk, and test whether radial SOS measurements predicted fracture risk.
Results: A total of 614 fractures occurred in 521 children over 24,719.3 person-years of follow-up. Overall fracture incidence was 24.9 per 1,000 person-years (95% CI 22.9 to 26.9). Fracture risk was higher in boys vs. girls (adjusted incidence rate ratio [aIRR] 2.10, 95% CI 1.77 to 2.49, P<0.0001) and in older vs. younger children (aIRR 1.18 per additional year of age, 95% CI 1.13 to 1.24, P<0.0001), peaking at age 14 in both boys (87.4 fractures per 1,000 boys per year, 95% CI 63.3 to 117.8) and girls (24.9 fractures per 1,000 girls per year, 95% CI 12.4 to 44.5, respectively). Fracture risk was also higher in children who smoked tobacco vs. those who did not (aIRR 2.20, 95% CI 1.09 to 4.43, P=0.03), while children whose parents were…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,456 participants or records.
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