High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease
High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease
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DOI：
10.1007/s00198-008-0764-2
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发表时间：
2009-06-01
影响因子：
4
通讯作者：
Kido, S.
中科院分区：
文献类型：
--
作者：
Kuwabara, A.;Tanaka, K.;Kido, S.
维生素K和D缺乏和骨密度（BMD）降低在炎症性肠病（IBD），特别是克罗恩病（CD）患者中非常普遍。本文对70例IBD患者的BMD、血浆维生素K、维生素D水平、骨密度（BMD）进行了测定。叶绿醌（PK）、甲基萘醌-7（MK-7）和25 OH-D;血清PTH，维生素K缺乏诱导的蛋白质与溃疡性结肠炎（UC）患者相比，CD患者血浆维生素K和25 OH-D浓度显著降低;血清PTH、PIVKA-II和ucOC水平显著升高;几乎所有测量部位的BMD评分显著降低。IBD患者骨维生素K缺乏多于肝维生素K缺乏。多元回归分析显示，血浆维生素K和25 OH-D浓度低是IBD患者BMD降低的独立危险因素，且与患者的脂肪摄入量有关，而与维生素摄入量无关，IBD患者BMD降低和维生素K、D缺乏的患病率较高，可能与维生素吸收不良有关。
Vitamin K and D deficiency and decreased bone mineral density (BMD) were highly prevalent in patients with inflammatory bowel disease (IBD), especially Crohn's disease (CD). Dietary intakes of these vitamins, however, were above the Japanese adequate intakes in IBD patients, suggesting that malabsorption is the basis for hypovitaminosis K and D and decreased BMD.We have studied the possible involvement of vitamin K and D deficiency in the pathogenesis of decreased BMD in IBD.Seventy patients with IBD were evaluated for their BMD; plasma levels of vitamin K; phylloquinone (PK), menaquinone-7 (MK-7), and 25OH-D; serum PTH, protein induced by vitamin K absence (PIVKA-II), and undercarboxylated osteocalcin (ucOC) levels; and their food intake.Compared with ulcerative colitis (UC) patients, CD patients had significantly lower plasma vitamin K and 25OH-D concentrations; significantly higher serum levels of PTH, PIVKA-II, and ucOC; and significantly lower BMD scores at almost all measurement sites. More IBD patients were vitamin K deficient in bone than in liver. Multiple regression analyses revealed that low plasma concentrations of vitamin K and 25OH-D were independent risk factors for low BMD and that they were associated with the patients' fat intake, but not with their intake of these vitamins.IBD patients have high prevalence of decreased BMD and vitamin K and D deficiency probably caused by malabsorption of these vitamins.