VITAMIN K-INDUCED CHANGES IN MARKERS FOR OSTEOBLAST ACTIVITY AND URINARY CALCIUM LOSS
VITAMIN K-INDUCED CHANGES IN MARKERS FOR OSTEOBLAST ACTIVITY AND URINARY CALCIUM LOSS
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DOI：
10.1007/bf01321883
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发表时间：
1993-08-01
影响因子：
4.2
通讯作者：
VERMEER, C
中科院分区：
文献类型：
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作者：
KNAPEN, MHJ;JIE, KSG;VERMEER, C
这项研究的目的是确定维生素K对钙和骨代谢标志物有影响的受试者，并检测维生素K诱导的这些标志物变化之间迄今未被注意到的相关性。我们的研究对象是明显健康的女性，我们检测了吸附羟基磷灰石前后的血清免疫反应性骨钙素(IROC)、血清总碱性磷酸酶(T-AP)和骨特异性碱性磷酸酶(B-AP)以及空腹尿钙和肌酐。我们描述了一项在145名接受维生素K(每天1毫克)治疗2周的妇女中进行的试验，以及在两组中每组70名绝经后妇女各进行一项前瞻性的安慰剂对照试验，疗程为3个月。结果发现，在老年妇女中，维生素K引起与羟基磷灰石高亲和力(IROC(Bound))的血清IROC水平升高，而与低亲和力(IROC(Free))的IROC水平保持不变。在接受安慰剂治疗的女性中，IROC(游离)/IROC(绑定)的比率在50岁左右从0.38变为0.65。这种变化在接受维生素K治疗的女性中没有发现。治疗3个月后，维生素K引起的IROC(结合)变化与B-AP变化相关，而IROC(游离)与尿钙排泄相关。在尿钙快速减少者中，维生素K导致钙排泄减少30%。提出IROC(Bound)可能是骨形成的标志，血清IROC(Free)可能是骨吸收的标志，血清IROC(Free)/IROC(Bound)比值可能成为骨骼重塑的标志。结论：维生素K的应用可能有助于减少绝经后妇女的尿钙丢失，尤其是钙快速减少者。IROC(游离)/IROC(结合)比总IROC提供了更多的信息，可能成为骨代谢的实用标志。
The objective of this study was to identify subjects in whom vitamin K has an effect on markers for calcium and bone metabolism and to detect hitherto-unnoticed correlations between vitamin K-induced changes in these markers. Participants in our studies were apparently healthy women, in whom we measured serum-immunoreactive osteocalcin (irOC) before and after adsorption to hydroxylapatite; total serum alkaline phosphatase (T-AP) and bone-specific alkaline phosphatase (B-AP); and fasting urinary calcium and creatinine. We describe a trial among 145 women who were treated with vitamin K (1 mg/day) for 2 weeks, and a prospective placebo-controlled trial among two groups each of 70 postmenopausal women with a treatment period of 3 months. It turned out that in elderly women vitamin K induced increased levels of serum irOC with a high affinity for hydroxylapatite (irOC(bound)), whereas that with low affinity (irOC(free)) remained unaffected. In placebo-treated women the ratio irOC(free)/irOC(bound) shifted from 0.38 to 0.65 around the 50th year of age. This shift was not found in vitamin K-treated women. After 3 months of treatment the vitamin K-induced changes in irOC(bound) were correlated with changes in B-AP, whereas irOC(free) was correlated to urinary calcium excretion. In fast losers of urinary calcium vitamin K induced a 30% decrease of calcium excretion. The hypothesis is put forward that irOC(bound) may be a marker for bone formation, that serum irOC(free) may be a marker for bone resorption, and that the serum irOC(free)/irOC(bound) ratio may become a marker for skeletal remodeling. It is concluded that vitamin K administration may help to reduce urinary calcium loss in postmenopausal women, notably in the fast losers of calcium. The ratio irOC(free)/irOC(bound) provides more information than total irOC and may become a practical marker for bone metabolism.