Bone Abstracts

Objective: Bone fractures are very common in children and their number is growing every year. Vitamin D has a proven role in the prevention of fractures. In the recent study, we have shown that children with low-energy fractures have significantly lower vitamin D blood levels compared to the children without fractures. Our data indicate that higher levels of vitamin D reduced the risk of fracture by 1.06 times (P<0.0005).

Past decade has seen increased interest in the role of vitamin K, especially K2 menaquinone-7, in bone health and prevention of bone fractures. There is a scarcity of research examining the effects of vitamin K deficiency on bone health in children and adolescent populations. The aim of the current study was to evaluate the vitamin D and K status in healthy children with low-energy fractures and in the control group without fractures.

Methods: The study group of 20 children aged 5 to 15 years old, with clinically confirmed low-energy fractures was compared with the control group of 19 healthy children, 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 undercarboxylated (ucOC) and carboxylated osteocalcin (cOC) serum concentrations were evaluated in every patient. Ratio of serum undercarboxylated osteocalcin to serum carboxylated osteocalcin ucOC:cOC - UCR - was used as an indicator of 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 vitamin D levels between the groups, however the statistically significant difference in the UCR was observed. The median UCR in the fracture group was 0.4709 compared with the control group value of 0.2445 (P<0.000004). In the logistic regression analysis, the odds ratio of the low-energy fractures for the UCR was calculated, with the increased risk of fractures by 9.62 times (P<0.003).

Conclusions: In this small sample study, the better vitamin K status expressed as the ratio of ucOC: cOC - UCR - have positively and statistically significantly correlated with lower rate of low-energy fracture incidence.

Disclosure: The authors declared no competing interests.