Associations between asthma status and radiologically confirmed fracture in children: A data‐linkage study. (3rd April 2018)

• Record Type: Journal Article
• Authors: Degabriele, Elizabeth L; Holloway, Kara L; Pasco, Julie A; Hyde, Natalie K; Vuillermin, Peter J; Williams, Lana J; Brennan‐Olsen, Sharon L
• Is Part Of: Journal of paediatrics and child health. Volume 54:Number 8(2018:Aug.)
• Page Start: 855
• Page End: 860
• Publication Date: 2018-04-03
• Subjects: asthma -- children -- fracture; Children -- Health and hygiene -- Periodicals; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/jpc.13895
• Languages: English
• ISSNs: 1034-4810

Abstract

Abstract : Aim: World‐wide, approximately 14% of children have prevalent asthma. As most bone accrual occurs in childhood, and data suggest a detrimental role in bone from asthma and/or medications, we investigated whether asthma was associated with radiologically confirmed fractures in a large cohort of children. Methods: Data from the Barwon Asthma Study (2005), a population‐based, cross‐sectional survey of all children attending 91 primary schools in the Barwon Statistical Division, were linked to the Geelong Osteoporosis Study Fracture Grid (2006–2007), a fracture register encompassing the Barwon Statistical Division ( n = 16 438; 50.5% boys; aged 3.5–13.6 years). Asthma, ascertained from parent‐reported symptoms using the International Study of Asthma and Allergies in Childhood questionnaire, was categorised as: (i) recent wheeze ; and number of (ii) recent wheezy episodes ; (iii) doctor visits for wheeze symptoms ; and (iv) doctor visits for asthma check‐ups . Using logistic regression analyses, stratified by sex and adjusted for age and medication use, we determined whether asthma was associated with radiologically confirmed fractures. Results: In total, 961 fractures were observed among 823 Barwon Asthma Study participants (5.9% of total sample; 61.1% boys). Recent wheeze and 1–3 recent wheezy episodes were associated with increased odds of fracture in boys (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.03–1.55; OR 1.40, 95% CI 1.12–1.77, respectively), but not girls (OR 1.03, 95% CI 0.78–1.37; OR 0.67, 95% CI 0.38–1.19). Results were independent of age, and sustained after adjustment for medication. Conclusions: Independent of age, asthma was associated with fracture for boys, but not girls. There is an imperative for strategies to promote bone health among children with asthma.