RE: "vitamin D and fracture risk in early childhood: a case-control study".
Abstract
In a case-control study of healthy children younger than 6 years of age—including 206 cases with radiographically-confirmed fractures of the appendicular skeleton and 343 controls matched for age, sex, height, and season of blood collection conducted in Toronto, Canada—Anderson et al. (1) evaluated the association between fracture risk and circulating 25-hydroxyvitamin D (25(OH)D) level as the primary objective. Conditional logistic regression analysis was used to adjust for fracture history, skin type, age- and sex-standardized waist circumference, outdoor free play time, parental income, birth weight, and soda intake. As a result, no association was found between serum 25(OH)D concentration and fracture risk (per 10-nmol/L increment, adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03; and 2 cups/day, aOR = 1.39 (95% CI: 0.85, 2.23)), whereas parent-reported children’s vitamin D supplementation was associated with a reduced risk of fractures (yes vs. no, aOR = 0.42, 95% CI: 0.25, 0.69) (1). Although the latter, but not the former, conflicts with the finding of the primary objective (i.e., no association between serum 25(OH)D concentration and fracture risk), one possible explanation of the conflicting results would be that the use of vitamin D supplements was linked to healthy lifestyle characteristics or protective parenting, as pointed out by the authors. Nevertheless, the growing skeleton in young children changes rapidly, and thus circulating…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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