The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Pre-school 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

Pre-school 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
Pre-school 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 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 American Society for Bone and Mineral Research.
EPIDEMIOLOGY, FRACTURE PREVENTION, FRACTURE RISK ASSESSMENT, NUTRITION, OBESITY, PEDIATRICS
0884-0431
1022-1030
Lane, Jennifer
098c8c8d-3721-4e1d-8ae3-0cc4e0926bd6
Butler, Katherine L.
79429b0e-4744-48dc-b3d3-7a6dd1cd8407
Poveda-Marina, Jose Luis
53fb2831-48d9-47fd-9966-ba0373b989c6
Martínez-Laguna, Daniel
330a147f-0b3a-41ff-8550-3dae76ac8ab2
Reyes, Carlen
1170cc74-1d60-44c6-a365-eca4c8b4b22e
de Bont, Jeroen
f19508f5-204f-43ed-8a48-d22e9588f87d
Javaid, M Kassim
ae65262a-c2ca-4ad9-ba8c-901fa1726db6
Logue, Jennifer
3e2dde66-79bd-481a-88eb-8bdec94e0122
Compston, Juliet
ffd1eb66-ec4f-45b9-9340-04520c456c52
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Duarte-Salles, Talita
ebd3d348-f59e-468e-afcc-4137abd8a676
Furniss, Dominic
44564b24-8b65-4b07-92f9-9f8486e9b533
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Lane, Jennifer
098c8c8d-3721-4e1d-8ae3-0cc4e0926bd6
Butler, Katherine L.
79429b0e-4744-48dc-b3d3-7a6dd1cd8407
Poveda-Marina, Jose Luis
53fb2831-48d9-47fd-9966-ba0373b989c6
Martínez-Laguna, Daniel
330a147f-0b3a-41ff-8550-3dae76ac8ab2
Reyes, Carlen
1170cc74-1d60-44c6-a365-eca4c8b4b22e
de Bont, Jeroen
f19508f5-204f-43ed-8a48-d22e9588f87d
Javaid, M Kassim
ae65262a-c2ca-4ad9-ba8c-901fa1726db6
Logue, Jennifer
3e2dde66-79bd-481a-88eb-8bdec94e0122
Compston, Juliet
ffd1eb66-ec4f-45b9-9340-04520c456c52
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Duarte-Salles, Talita
ebd3d348-f59e-468e-afcc-4137abd8a676
Furniss, Dominic
44564b24-8b65-4b07-92f9-9f8486e9b533
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9

Lane, Jennifer, Butler, Katherine L., Poveda-Marina, Jose Luis, Martínez-Laguna, Daniel, Reyes, Carlen, de Bont, Jeroen, Javaid, M Kassim, Logue, Jennifer, Compston, Juliet, Cooper, Cyrus, Duarte-Salles, Talita, Furniss, Dominic and Prieto-Alhambra, Daniel (2020) Pre-school 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. Journal of Bone and Mineral Research, 35 (6), 1022-1030. (doi:10.1002/jbmr.3984).

Record type: Article

Abstract

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 American Society for Bone and Mineral Research.

Text
Manuscript_JBMR_symplectic (002) - Accepted Manuscript
Download (170kB)
Text
Supplementary file_symplectic_condensed
Restricted to Repository staff only
Request a copy
Text
Figure1_forCC
Restricted to Repository staff only
Request a copy
Text
figure 2_forCC
Restricted to Repository staff only
Request a copy
Text
Figure 3_forCC
Restricted to Repository staff only
Request a copy

Show all 5 downloads.

More information

Accepted/In Press date: 7 February 2020
e-pub ahead of print date: 7 April 2020
Keywords: EPIDEMIOLOGY, FRACTURE PREVENTION, FRACTURE RISK ASSESSMENT, NUTRITION, OBESITY, PEDIATRICS

Identifiers

Local EPrints ID: 439622
URI: http://eprints.soton.ac.uk/id/eprint/439622
ISSN: 0884-0431
PURE UUID: 3ead06c4-5e7c-4023-934d-4b3287c49b52
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 28 Apr 2020 16:35
Last modified: 26 Nov 2021 06:55

Export record

Altmetrics

Contributors

Author: Jennifer Lane
Author: Katherine L. Butler
Author: Jose Luis Poveda-Marina
Author: Daniel Martínez-Laguna
Author: Carlen Reyes
Author: Jeroen de Bont
Author: M Kassim Javaid
Author: Jennifer Logue
Author: Juliet Compston
Author: Cyrus Cooper ORCID iD
Author: Talita Duarte-Salles
Author: Dominic Furniss
Author: Daniel Prieto-Alhambra

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×