Bone mineral density and risk factors of osteoporosis in children

Abstract

Background: Osteoporosis (OP) is a worldwide problem that could affect children. Aim of the work: to evaluate bone mineral density (BMD) and assess risk factors of OP in children. Patients and methods: This study was carried out on 960 children (410 male and 550 female). All children were subjected to full medical, nutritional history, clinical examination; laboratory investigations, dorsolumbar plain x-ray and dual energy X-ray absorptiometry (DEXA) scan. Results: The children were 57.3% females and 42.7% males (F: M 1.3:1) with a mean age of 9.3 ± 2.7 years. The frequency of low BMD was 28.3% (n = 272), while 11.2% (n = 107) were osteoporotic. OP was idiopathic in 4.7% and secondary in 95.3%. In OP children there was history of vertebral fracture in 91, 2 long bone fractures in 13 and 3 long bone fractures in 3 following low impact traumas. The risk factors of OP were unhealthy nutrition (89.7%), anemia (87.9%), underweight (81.3%), bronchial asthma (68.2%), diabetes mellitus (58.9%), epilepsy (12.2%), delayed puberty (8.4%), chronic kidney disease (4.3%), rheumatic diseases (4.3%) and hypothyroidism (1.9%). There was a significant difference between those with and without OP as regards serum calcium, phosphorous, alkaline phosphatase (p < 0.001) and most common risk factors of OP among studied children (p ≤ 0.05). Conclusions: Osteoporosis is frequent in children and unhealthy nutrition is the most common risk factor. OP is frequent among chronic disease as anemia, diabetes mellitus, bronchial asthma and epilepsy. Raising awareness among rheumatologists, pediatricians and family medicine physicians about this alarming condition is warranted to early detect and treat cases.