Vitamin K status in patients with Crohn's disease and relationship to bone turnover
Vitamin K status in patients with Crohn's disease and relationship to bone turnover
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DOI：
10.1111/j.1572-0241.2004.40071.x
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发表时间：
2004-11-01
影响因子：
9.8
通讯作者：
Cashman, KD
中科院分区：
文献类型：
--
作者：
Duggan, P;O'Brien, M;Cashman, KD
背景：克罗恩病（CD）患者骨质减少的患病率很高。有一些证据表明，某些骨活性营养素（包括维生素 K 和 D）的缺乏可能在这种骨质流失中起部分作用。 目的：将目前处于缓解期的 CD 患者与年龄和性别匹配的对照组的维生素 K 摄入量和状态进行比较，并进一步研究这些患者中维生素 K 状态与骨转换之间的关系。 受试者：CD 患者（n = 44；平均年龄：36.9 岁） 分别从科克大学医院和科克市地区招募了对照组 (n = 44)。 方法：分析血液中总骨钙素和羧化不足 (Glu)-骨钙素，分析尿液中 I 型胶原交联 N-端肽 (NTx)。通过食物频率问卷估算维生素 K-1 摄入量。结果：CD 患者的维生素 K-1 摄入量往往低于对照组（平均值 (SD) 分别为 117 (82) 和 148 (80) 杯/天；p = 0.059）。 CD 患者的 Glu 和 NTx 浓度高于对照组（平均值 (SD) 分别为 5.1 (3.1) 和 3.9 (2.1) ng/ml；Glu 的 p = 0.03；分别为 49 (41) 和 25.8 (19.5) nM BCE/mM 肌酐；NTx 的 p = 0.001）。在 CD 患者中，Glu 与 NTx 显着相关（r = 0.488；p < 0.001），即使在控制了年龄、性别、维生素 D 状态、钙摄入量和皮质类固醇使用后也是如此。 结论：CD 患者的维生素 K 状态低于健康对照。此外，CD的骨吸收率与维生素K状态呈负相关，这表明它可能是CD相关骨质减少的另一个病因因素。
BACKGROUND: There is a high prevalence of osteopenia among patients with Crohn's disease (CD). There is some evidence that a deficiency of certain bone-active nutrients (including vitamins K and D) may have a partial role in this bone loss.AIMS: To compare the intake and the status of vitamin K in CD patients, currently in remission, with age and sex-matched controls, and furthermore to investigate the relationship between vitamin K status and bone turnover in these patients.SUBJECTS: CD patients (n = 44; mean age: 36.9 yr) and matched controls (n = 44) were recruited from the Cork University Hospital and Cork City area, respectively.METHODS: Bloods were analyzed for the total and undercarboxylated (Glu)-osteocalcin and urine analyzed for cross-linked N-telopeptides of type I collagen (NTx). Vitamin K-1 intake was estimated by food frequency questionnaire.RESULTS: Vitamin K-1 intake in CD patients tended to be lower than that of controls (mean (SD), 117 (82) vs 148 (80) mug/d, respectively; p = 0.059). Glu and NTx concentrations in CD patients were higher than controls (mean (SD), 5.1 (3.1) vs 3.9 (2.1) ng/ml, respectively; p = 0.03 for Glu; and 49 (41) vs 25.8 (19.5) nM BCE/mM creatinine, respectively; p = 0.001 for NTx). In CD patients, Glu was significantly correlated with NTx (r = 0.488; p < 0.001), even after controlling for age, gender, vitamin D status, calcium intake, and corticosteroid use.CONCLUSION: Vitamin K status of CD patients was lower than that of the healthy controls. Furthermore, the rate of bone resorption in the CD was inversely correlated with vitamin K status, suggesting that it might be another etiological factor for CD-related osteopenia.