Deficiency of Vitamin K2, Fracture Healing, Vitamin D3
Conditions
Keywords
vitamin D, vitamin K2, low-energy fractures, fracture healing, children
Brief summary
a prospective, three- month, randomized, double-blind, placebo-controlled, intervention trial (RDBPC), investigating the effect of vitamin K2 (menaquinone-7) and vitamin D3 on the healing process of low-energy bone fractures in children and adolescents
Detailed description
At the admission of patients to the orthopedic outpatient clinic, presence of low- energy fractures will be established based on the anamnesis, physical examination and radiological evaluation. Tests to obtain the baseline blood levels of vitamin D3 will be performed, and only children with vitamin D3 levels lower than 30ng/ml in the blood will be included in the study. The selected population will then be randomly assigned by an independent investigator to the three study groups, receiving daily for three months identical- looking soft gel capsules (1 capsule/patient/day) containing supplements of vitamin D3 2,000 IU, 90 mcg of vitamin K2 as menaquinone-7 combined with 2,000 IU D3, and olive oil-containing placebo capsules respectively. During the 3-month follow-up visits to the outpatient orthopedic clinic, the pediatric orthopedist will examine the patient, evaluate the X-ray, and determine the progress in bone union and the range of joint motion. The patients will visit the clinic on weeks 1,2,4,6,8, and 12. The compliance taking the supplements will be assessed by registering a pill count returned by a patient during the scheduled visit. The blood samples will be collected upon admission to the study, day 0, and after the 3-month regimen. The blood samples will be collected for evaluation of bone turnover markers and the status of vitamin K and vitamin D3. The primary evaluation endpoints will include: the dynamics of fracture healing, changes in levels of osteocalcin, and vitamin K and vitamin D3 levels against the placebo group. The bone fracture healing milestones will be based on bone union defined as the absence of pain and the presence of bridging callus in three of the four cortices seen on the front rear projection and lateral radiographic views of the bone. Delayed union is defined as incomplete consolidation at 90 Days
Interventions
if supplementation of vitamin D and K2 changes the time to fracture healing
if supplementation of vitamin D alone changes the time to fracture healing
Placebo control group
Sponsors
Study design
Masking description
double-blind, placebo, same looking capsules
Intervention model description
a prospective, three- month, randomized, double-blind, placebo-controlled, intervention trial (RDBPC),
Eligibility
Inclusion criteria
* Age \< 18 years * Presence of low-energy fracture * Vitamin D serum level \<30ng/ml
Exclusion criteria
* Age \> 18 years * Lack of low-energy bone fracture * Oral anticoagulants treatments, which interfere with vitamin K cycle * Current supplementation with vitamin vitamins K2 or vitamin D3 * Osteogenesis imperfecta and other bone diseases * Vitamin D concentration \> 30ng/ml
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| time to bone union | 3 months | The bone fracture healing milestones will be based on bone union defined as the absence of pain and the presence of bridging callus in three of the four cortices seen on the AnteroPosteral and lateral radiographs |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Vitamin D concentration changes | 3 months | changes in vitamin D serum concentration |
| Vitamin K2 concentration changes | 3 months | changes in vitamin K2 serum concentration |
| Changes in bone markers concentration | 3 months | Changes in bone-specific alkaline phosphatase (BALP), N-terminal telopeptide (NTX) |
Countries
Poland