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Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain
This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the In...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7116071/ https://www.ncbi.nlm.nih.gov/pubmed/32266748 http://dx.doi.org/10.1002/jbmr.3984 |
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author | Lane, Jennifer CE Butler, Katherine L Poveda‐Marina, Jose Luis Martinez‐Laguna, Daniel Reyes, Carlen de Bont, Jeroen Javaid, Muhammad Kassim Logue, Jennifer Compston, Juliet E Cooper, Cyrus Duarte‐Salles, Talita Furniss, Dominic Prieto‐Alhambra, Daniel |
author_facet | Lane, Jennifer CE Butler, Katherine L Poveda‐Marina, Jose Luis Martinez‐Laguna, Daniel Reyes, Carlen de Bont, Jeroen Javaid, Muhammad Kassim Logue, Jennifer Compston, Juliet E Cooper, Cyrus Duarte‐Salles, Talita Furniss, Dominic Prieto‐Alhambra, Daniel |
author_sort | Lane, Jennifer CE |
collection | PubMed |
description | This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the Information System for Research in Primary Care (SIDIAP) platform in Catalonia, Spain. Data were collected from 296 primary care centers representing 74% of the regional pediatric population. A total of 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (±6 months) between 2006 and 2013 were included, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. BMI was calculated at age 4 years and classified using WHO growth tables, and fractures were identified using previously validated ICD10 codes in electronic primary care records, divided by anatomical location. Actuarial lifetables were used to calculate cumulative incidence. Cox regression was used to investigate the association of BMI category and fracture risk with adjustment for socioeconomic status, age, sex, and nationality. Median follow‐up was 4.90 years (interquartile range [IQR] 2.50 to 7.61). Cumulative incidence of any fracture during childhood was 9.20% (95% confidence interval [CI] 3.79% to 14.61%) for underweight, 10.06% (9.82% to 10.29%) for normal weight, 11.28% (10.22% to 12.35%) for overweight children, and 13.05% (10.69% to 15.41%) for children with obesity. Compared with children of normal range weight, having an overweight and obese range BMI was associated with an excess risk of lower limb fracture (adjusted hazard ratio [HR] = 1.42 [1.26 to 1.59]; 1.74 [1.46 to 2.06], respectively) and upper limb fracture (adjusted HR = 1.10 [1.03 to 1.17]; 1.19 [1.07 to 1.31]). Overall, preschool children with an overweight or obese range BMI had increased incidence of upper and lower limb fractures in childhood compared with contemporaries of normal weight. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research. |
format | Online Article Text |
id | pubmed-7116071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71160712020-12-01 Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain Lane, Jennifer CE Butler, Katherine L Poveda‐Marina, Jose Luis Martinez‐Laguna, Daniel Reyes, Carlen de Bont, Jeroen Javaid, Muhammad Kassim Logue, Jennifer Compston, Juliet E Cooper, Cyrus Duarte‐Salles, Talita Furniss, Dominic Prieto‐Alhambra, Daniel J Bone Miner Res Original Articles This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the Information System for Research in Primary Care (SIDIAP) platform in Catalonia, Spain. Data were collected from 296 primary care centers representing 74% of the regional pediatric population. A total of 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (±6 months) between 2006 and 2013 were included, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. BMI was calculated at age 4 years and classified using WHO growth tables, and fractures were identified using previously validated ICD10 codes in electronic primary care records, divided by anatomical location. Actuarial lifetables were used to calculate cumulative incidence. Cox regression was used to investigate the association of BMI category and fracture risk with adjustment for socioeconomic status, age, sex, and nationality. Median follow‐up was 4.90 years (interquartile range [IQR] 2.50 to 7.61). Cumulative incidence of any fracture during childhood was 9.20% (95% confidence interval [CI] 3.79% to 14.61%) for underweight, 10.06% (9.82% to 10.29%) for normal weight, 11.28% (10.22% to 12.35%) for overweight children, and 13.05% (10.69% to 15.41%) for children with obesity. Compared with children of normal range weight, having an overweight and obese range BMI was associated with an excess risk of lower limb fracture (adjusted hazard ratio [HR] = 1.42 [1.26 to 1.59]; 1.74 [1.46 to 2.06], respectively) and upper limb fracture (adjusted HR = 1.10 [1.03 to 1.17]; 1.19 [1.07 to 1.31]). Overall, preschool children with an overweight or obese range BMI had increased incidence of upper and lower limb fractures in childhood compared with contemporaries of normal weight. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research. John Wiley & Sons, Inc. 2020-04-07 2020-06 /pmc/articles/PMC7116071/ /pubmed/32266748 http://dx.doi.org/10.1002/jbmr.3984 Text en © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Lane, Jennifer CE Butler, Katherine L Poveda‐Marina, Jose Luis Martinez‐Laguna, Daniel Reyes, Carlen de Bont, Jeroen Javaid, Muhammad Kassim Logue, Jennifer Compston, Juliet E Cooper, Cyrus Duarte‐Salles, Talita Furniss, Dominic Prieto‐Alhambra, Daniel Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title | Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title_full | Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title_fullStr | Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title_full_unstemmed | Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title_short | Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain |
title_sort | preschool obesity is associated with an increased risk of childhood fracture: a longitudinal cohort study of 466,997 children and up to 11 years of follow‐up in catalonia, spain |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7116071/ https://www.ncbi.nlm.nih.gov/pubmed/32266748 http://dx.doi.org/10.1002/jbmr.3984 |
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