Abstract
Objective: In the past decades, an increased interest in the roles of vitamin D and K has become evident, in particular in relation to bone health and prevention of bone fractures. The aim of the current study was to evaluate vitamin D and K status in children with low-energy fractures and in children without fractures. Methods: The study group of 20 children (14 boys, 6 girls) aged 5 to 15 years old, with radiologically confirmed low-energy fractures was compared with the control group of 19 healthy children (9 boys, 10 girls), aged 7 to 17 years old, without fractures. Total vitamin D (25(OH)D3 plus 25(OH)D2), calcium, BALP (bone alkaline phosphatase), NTx (N-terminal telopeptide), and uncarboxylated (ucOC) and carboxylated osteocalcin (cOC) serum concentrations were evaluated. Ratio of serum uncarboxylated osteocalcin to serum carboxylated osteocalcin ucOC:cOC (UCR) was used as an indicator of bone vitamin K status. Logistic regression models were created to establish UCR influence for odds ratio of low-energy fractures in both groups. Results: There were no statistically significant differences in the serum calcium, NTx, BALP, or total vitamin D levels between the two groups. There was, however, a statistically significant difference in the UCR ratio. The median UCR in the fracture group was 0.471 compared with the control group value of 0.245 (p < 0.0001). In the logistic regression analysis, odds ratio of low-energy fractures for UCR was calculated, with an increased risk of fractures by some 78.3 times. Conclusions: In this pilot study, better vitamin K status expressed as the ratio of ucOC:cOC-UCR—is positively and statistically significantly correlated with lower rate of low-energy fracture incidence.
Highlights
Bone fractures are common injuries during childhood and this number is increasing [1,2,3,4,5,6]
We have shown that children with low-energy fractures have statistically significantly lower circulating vitamin D levels compared to children without fractures [9,10], and our data indicate that higher levels of vitamin D reduce the risk of fracture [10]
The levels of bone alkaline phosphatase (BALP) and NTX did not differ significantly in children with fractures compared with control children without fractures
Summary
Janusz Popko 1 , Michał Karpiński 1 , Sylwia Chojnowska 2 , Katarzyna Maresz 3 , Robert Milewski 4 , Vladimir Badmaev 5 and Leon J.
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