Abstract
董虹孛,程红,侯冬青,朱忠信,郁兆仓,王宏健,高爱钰,赵小元,王文鹏,米杰.学龄儿童青少年骨折新发特点及其影响因素的研究[J].Chinese journal of Epidemiology,2021,42(3):448-454
学龄儿童青少年骨折新发特点及其影响因素的研究
Incidence and risk factors of pediatric fractures in school-age children and adolescents in Beijing
Received:August 07, 2020  
DOI:10.3760/cma.j.cn112338-20200807-01039
KeyWord: 儿童  骨折  发生率  影响因素  队列研究
English Key Word: Children  Fracture  Incidence  Risk factor  Cohort study
FundProject:国家重点研发计划(2016YFC0900600,2016YFC0900602);国家自然科学基金(71904132)
Author NameAffiliationE-mail
Dong Hongbo Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China  
Cheng Hong Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China  
Hou Dongqing Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China  
Zhu Zhongxin Beijing Miyun Primary and Secondary School Health Center, Beijing 101500, China  
Yu Zhaocang Beijing Tongzhou Primary and Secondary School Health Center, Beijing 101100, China  
Wang Hongjian Beijing Fangshan Primary and Secondary School Health Center, Beijing 102400, China  
Gao Aiyu Beijing Dongcheng Primary and Secondary School Health Center, Beijing 100009, China  
Zhao Xiaoyuan Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China  
Wang Wenpeng Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China  
Mi Jie Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China jiemi12@vip.sina.com 
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Abstract:
      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12 056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。
English Abstract:
      Objective To investigate the incidence and risk factors of pediatric fracture in school-age children and adolescents in Beijing. Methods A total of 12 056 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.
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