Long Bone Fracture, Vitamin D
Conditions
Brief summary
Studies in chickens show that blood levels of a particular form of vitamin D (called 24,25-dihydroxvitamin D) increase after bone fracture. Laboratory studies show that this form of vitamin D helps the bone healing process in chickens. The investigators want to find out whether blood levels of this form of vitamin D increase after bone fracture in humans. Previous research studies have not addressed this question. The results of this research could eventually lead to the development of new treatments to help bone healing after fracture. Patients will be asked to take part in this study if they are aged 16 years or older and come to the Royal London Hospital with a broken bone in the arm or leg or collar bone (clavicle). They will be asked to give a 20ml (about 4 teaspoons) blood sample on three occasions: at the start of the study, at 5-14 days after the fracture; and at 4-10 weeks after the fracture. The rest of their normal care would not be affected. Follow-up blood samples will be timed to coincide with routine clinic visits which are scheduled as part of normal clinical care. Patients' vitamin D level will be measured as part of the study, and those who have a low vitamin D level will be informed about this, and advised about appropriate vitamin D supplementation. The investigators will let the patient or their GP know if any blood tests are abnormal
Interventions
OTHERNo intervention
No intervention
Sponsors
London Deanery
Barts & The London NHS Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Any cross-shaft long bone or clavicle fracture within last 12 hours 2. Able to give written informed consent 3. Age ≥ 16 years 4. Fused physes (physiologically adult)
Exclusion criteria
1. Taking medication affecting vitamin D metabolism - carbamazepine, phenobarbital, phenytoin or primidone 2. Taking vitamin D supplement \> 800 IU/day 3. Abdominal visceral injury, pleural injury (except pneumothorax), spinal cord injury, or GCS \< 15 at presentation to hospital 4. Known Paget's disease, osteopetrosis, metastatic bone cancer, or primary bone cancer 5. Current prisoners 6. Currently taking part in another clinical research project
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Serum concentration of 24,25-dihyroxyvitamin D at 5-14 days post cross sectional long bone or clavicle fracture, compared with baseline. | 5-14 days post fracture |
Secondary
| Measure | Time frame |
|---|---|
| Serum concentrations of vitamin D metabolites (including 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D) and markers of bone healing | Baseline, 5-14 days, and 4-10 weeks post fracture |
| Peripheral blood expression of genes encoding enzymes in the vitamin D metabolic pathway. | Baseline, 5-14 days, and 4-10 weeks post fracture |
Countries
United Kingdom
Outcome results
None listed