Increased Risk of Blount Disease in Obese Children and Adolescents With Vitamin D Deficiency

Montgomery, Corey; Young, Karen; Austen, Mark A.; Jo, Chan‐Hee; Blasier, R. Dale; Ilyas, Mohammad

doi:10.1097/bpo.0b013e3181f5a0b3

Cited by 62 publications

(38 citation statements)

References 23 publications

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“…Lifetime fracture history, as determined by parental interview, was significantly higher in children with 25(OH)D<50nmol/l (18.4% vs 8.4%, p=0.006) [54]. In a study of 890 obese children in Arkansas, USA, 22% were defined as vitamin D deficient (25(OH)D<40nmol/l) and had a 1.82 increased risk of a documented fracture history than the vitamin D replete children (p=0.05) [69]. Interestingly, when both parentally reported and hospital documented fractures were considered, this excess risk was no longer present.…”

Section: Fracture In Non-rachictic Childrenmentioning

confidence: 99%

Vitamin D and skeletal health in infancy and childhood

et al. 2014

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During growth, severe vitamin D deficiency in childhood can result in symptomatic hypocalcaemia and rickets. Despite the suggestion from some studies of a secular increase in the incidence of rickets, this observation may be driven more by changes in population demographics than a true alteration to age, sex and ethnicity-specific incidence rates; indeed rickets remains uncommon overall and is rarely seen in fair-skinned children. Additionally, the impact of less severe vitamin D deficiency and insufficiency has received much interest in recent years, and in this review we consider the evidence relating vitamin D status to fracture risk and bone mineral density (BMD) in childhood and adolescence. We conclude that there is insufficient evidence to support the suggestion that low serum 25-hydroxyvitamin D [25(OH)D] increases childhood fracture risk. Overall, the relationship between 25(OH)D and BMD is inconsistent across studies and across skeletal sites within the same study; however there is evidence to suggest that vitamin D supplementation in children with the lowest levels of 25(OH)D might improve BMD. High quality randomised trials are now required to confirm this benefit.

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Section: Fracture In Non-rachictic Childrenmentioning

confidence: 99%

Vitamin D and skeletal health in infancy and childhood

et al. 2014

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“…In a retrospective analysis of 890 obese children with a mean BMI of ≈35 kg/m 2 , higher BMI was associated with increased risk of Blount disease. 106 A recent study of 41 adolescents presenting with Blount disease to a children's hospital reported a mean BMI of 41 kg/m 2 , which represents severe obesity by any standard. 107 Therefore, the evidence suggests that severe pediatric obesity is a significant risk factor for Blount disease.…”

Section: Nonalcoholic Fatty Liver Diseasementioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

858

804

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espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

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“…[26][27][28] The levels of vitamin D are inversely proportional to obesity in adolescents and young adults. 5,23,29 The relationship between vitamin D and the development of SCFE, however, has not been clearly established. Therefore, we sought to evaluate whether children and adolescents who developed "idiopathic" SCFE, may have had vitamin D insufficiency or deficiency leading to subclinical rickets predisposing SCFE.…”

Section: Discussionmentioning

confidence: 96%