Bone Outcomes, Obesity, Sunlight, and Trauma in Children

NCT ID: NCT07143552

Last Updated: 2025-09-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-07-01

Study Completion Date

2026-09-30

Brief Summary

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Prospective case-control study of children (3-15 years) after low-energy trauma. We compare serum bone metabolic markers (25OHD, PTH, ALP, calcium, phosphate), BMI/percentile, and dietary calcium intake between fracture and non-fracture presentations. Blood is collected within 7 days (non-fasting; samples on ice for PTH). Primary aim: association of ALP and calcium with fracture status; secondary aims: vitamin D status, BMI percentile, and a composite Bone Risk Score (≥3). Analyses: group comparisons, logistic regression, ROC.

Detailed Description

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Low-energy fractures in children are a common cause of morbidity and may reflect underlying skeletal fragility. Emerging evidence suggests that hypovitaminosis D, obesity, and abnormal bone metabolism play important roles in fracture risk. However, the combined effect of these factors remains insufficiently studied, particularly in pediatric populations.

This study is designed as a prospective case-control investigation to explore the relationship between vitamin D status, bone metabolic markers, and obesity in children presenting with trauma. Children aged 3-15 years with low-energy trauma will be recruited and divided into two groups: those with radiologically confirmed fractures (cases) and those with similar trauma but without fractures (controls).

Baseline assessments include anthropometric measurements, dietary calcium intake through a food-frequency questionnaire, and laboratory evaluation of bone metabolism. Blood samples will be obtained within 7 days of the trauma and processed under standardized conditions to measure 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphate. Samples are collected non-fasting and stored on ice to minimize variability in PTH measurement.

The primary outcome is the association of fracture occurrence with serum alkaline phosphatase (ALP) levels. Secondary outcomes include serum calcium, 25OHD concentration, a composite bone risk score, and body mass index (BMI) percentile. Outcomes are analyzed using descriptive statistics, group comparisons, and logistic regression to identify independent predictors of fracture risk.

The study aims to provide novel insights into the multifactorial etiology of pediatric fractures. By integrating metabolic, nutritional, and anthropometric data, the project seeks to establish a more comprehensive risk profile that can guide preventive strategies and inform clinical practice in pediatric bone health.

Conditions

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Pediatric Fractures Hypovitaminosis D Obesity and Overweight

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Fracture group

Children aged 3-15 years with radiologically confirmed low-energy fractures.

No interventions assigned to this group

Control group

Children aged 3-15 years with low-energy trauma but no radiological evidence of fracture.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* 3-15 years;
* low-energy trauma;
* cases = radiographic fracture; controls = no fracture.

Exclusion Criteria

* chronic renal/liver disease;
* primary hypo-/hyperparathyroidism;
* hypophosphatemic rickets;
* neuromuscular disorders;
* corticosteroids/bisphosphonates;
* unclear diagnosis/treatment.
Minimum Eligible Age

3 Years

Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Paracelsus Medical University

OTHER

Sponsor Role lead

Responsible Party

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Andrea Cosentino

Medical Doctor, Principal Investigator, Department of Orthopedics, Attending PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea Cosentino, MD

Role: PRINCIPAL_INVESTIGATOR

Franz Tappeiner Hospital; Paracelsus Medical University

Locations

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Kaiser Franz Joseph Hospital

Brixen, Bolzano, Italy

Site Status RECRUITING

Franz Tappeiner Hospital

Meran, Bolzano, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Andrea Cosentino, MD

Role: CONTACT

+393334503625

Facility Contacts

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Andrea Cosentino, MD

Role: primary

+39 3334503625

Andrea Cosentino, MD

Role: primary

+393334503625

References

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Gonzalez N, Nahmias J, Schubl S, Swentek L, Smith BR, Nguyen NT, Grigorian A. Obese adolescents have higher risk for severe lower extremity fractures after falling. Pediatr Surg Int. 2023 Jul 19;39(1):235. doi: 10.1007/s00383-023-05524-9.

Reference Type BACKGROUND
PMID: 37466766 (View on PubMed)

Ergun T, Cansever M. Comparison of 25-OH vitamin D levels between children with upper and those with lower extremity fractures: A prospective case-control study. Acta Orthop Traumatol Turc. 2022 Mar;56(2):76-80. doi: 10.5152/j.aott.2022.21018.

Reference Type BACKGROUND
PMID: 35416156 (View on PubMed)

Moore DM, O'Sullivan M, Kiely P, Noel J, O'Toole P, Kennedy J, Moore DP, Kelly P. Vitamin D levels in Irish children with fractures: A prospective case-control study with 5 year follow-up. Surgeon. 2022 Apr;20(2):71-77. doi: 10.1016/j.surge.2021.02.015. Epub 2021 Apr 24.

Reference Type BACKGROUND
PMID: 33903053 (View on PubMed)

Yang G, Lee WYW, Hung ALH, Tang MF, Li X, Kong APS, Leung TF, Yung PSH, To KKW, Cheng JCY, Lam TP. Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis. Osteoporos Int. 2021 Jul;32(7):1287-1300. doi: 10.1007/s00198-020-05814-1. Epub 2021 Mar 11.

Reference Type BACKGROUND
PMID: 33704541 (View on PubMed)

Clark EM, Ness AR, Bishop NJ, Tobias JH. Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res. 2006 Sep;21(9):1489-95. doi: 10.1359/jbmr.060601.

Reference Type BACKGROUND
PMID: 16939408 (View on PubMed)

Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Michigami T, Tiosano D, Mughal MZ, Makitie O, Ramos-Abad L, Ward L, DiMeglio LA, Atapattu N, Cassinelli H, Braegger C, Pettifor JM, Seth A, Idris HW, Bhatia V, Fu J, Goldberg G, Savendahl L, Khadgawat R, Pludowski P, Maddock J, Hypponen E, Oduwole A, Frew E, Aguiar M, Tulchinsky T, Butler G, Hogler W. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016 Feb;101(2):394-415. doi: 10.1210/jc.2015-2175. Epub 2016 Jan 8.

Reference Type BACKGROUND
PMID: 26745253 (View on PubMed)

Other Identifiers

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prot. N. 0098306-BZ REG01

Identifier Type: -

Identifier Source: org_study_id

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