学龄儿童青少年骨折新发特点及其影响因素的研究

目的了解学龄儿童青少年的骨折发生特点及影响因素。方法选取参加“儿童青少年心血管与骨健康促进项目”2017年基线调查和2019年队列随访中骨折调查资料完整的12056名(男童49.4%)学龄儿童青少年作为研究对象。采用logistic回归分析年龄分组、BMI分组、骨折史及生活行为方式等因素与骨折发生风险的关系。结果北京地区学龄儿童青少年骨折的2年累计发生率为3.1%(95%CI:2.8%~3.4%),其中男童(4.1%)明显高于女童(2.1%),P<0.01;且在男童中呈现随年龄递增而在女童中递减的特点。骨折的发生部位以上肢为主(69.0%),不同性别年龄组间差异无统计学意义。此外,在男女童中均发现,骨折史是未来骨折发生的重要危险因素(男童:RR=1.81,95%CI:1.18~2.64;女童:RR=3.11,95%CI:1.74~5.13)。另在男童中发现,较长时间与频率的中高强度身体活动(≥120 min/d)和频繁饮用含糖饮料(≥1次/周)也可增加其未来骨折发生风险。结论北京地区学龄儿童青少年骨折率受到性别、年龄、骨折史和生活行为习惯的影响。应面向不同个体开展相应的预防策略,以避免儿童骨折的发生。

Incidence and risk factors of pediatric fractures in school-age children and adolescents in Beijing

Objective To investigate the incidence and risk factors of pediatric fracture in school-age children and adolescents in Beijing.Methods A total of 12056 students with complete fracture data of 2017 baseline survey and 2019 follow-up survey of School-based Cardiovascular and Bone Health(SCVBH)Promotion Program in Beijing were selected as study subjects.Logistic regression model was used to analyze associations of fracture incidence with age,BMI,fracture history and lifestyle.Results The 2-year accumulative incidence rate of pediatric fracture was 3.1%(95%CI:2.8%-3.4%)in school-age children and adolescents in Beijing,which was much higher in boys(4.1%)than in girls(2.1%)and increased with age in boys but decreased with age in girls.Fractures mainly occurred at upper-limb(69.0%),no gender and age specific significant in fracture sites were observed.Fracture history was the risk factor for fracture incidence in both boys and girls(boys:RR=1.81,95%CI:1.18-2.64;girls:RR=3.11,95%CI:1.74-5.13).In addition,higher duration and frequency of moderate to vigorous physical activities(≥120 min/day)and frequent consumption of sugar sweetened beverage(≥1 time/week)were also found to increase fracture risk in boys.Conclusion The incidence of pediatric fracture was associated with gender,age,fracture history and lifestyle habits in school-age children and adolescents in Beijing.Targeted strategies are needed to prevent childhood fracture.