Two-year randomized controlled trial of vitamin K1 (phylloquinone) and vitamin D3 plus calcium on the bone health of older women
Two-year randomized controlled trial of vitamin K1 (phylloquinone) and vitamin D3 plus calcium on the bone health of older women
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DOI：
10.1359/jbmr.070116
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发表时间：
2007-04-01
影响因子：
6.2
通讯作者：
Shearer, Martin J.
中科院分区：
文献类型：
--
作者：
Bolton-Smith, Caroline;McMurdo, Marion E. T.;Shearer, Martin J.
简介：高膳食维生素K-1的假定有益作用（叶绿醌）对BMD和与维生素D的交互益处的可能性在健康的苏格兰妇女中在2年双盲、安慰剂对照试验中研究：>= 60岁。材料和方法：健康的非乳腺炎妇女（n = 244）被随机接受（1）安慰剂，（2）200 μ g/天维生素K1，（3）10 μ g（400 IU）维生素D-3加1000 mg钙/天，或（4）组合维生素K和D3加钙。基线和6个月的测量包括髋关节和腕关节的DXA骨矿物质扫描，骨转换标志物和维生素状态。补充效果进行了测试，使用多变量一般线性模型，充分调整基线和潜在的混杂variables.Results：显着的骨矿物质损失，只看到在中远端桡骨，但组间无显着差异。然而，服用维生素K和维生素D加钙的妇女在桡骨远端部位的BMD和BMC均显示出显著和持续的增加。血清状态指标对分别补充维生素K和维生素D有显著反应。2年多来，血清维生素K增加了157%（p < 0.001），低羧基化骨钙素的百分比（%GluOC）降低了51%。（p < 0.001），血清25-羟基维生素D [25（OH）D]增加17%（p < 0.001），PTH降低11%（p = 0.049）。这些结果提供了健康老年妇女从营养相关的维生素K摄入中适度协同作用的证据，同时补充钙和适量的维生素D3，以提高桡骨远端的BMC，该部位主要由小梁骨组成。维生素K对骨钙素γ-羧化的显著增加可能具有长期益处，并且可能通过增加维生素K的膳食摄入而不是通过补充来实现。
Introduction: The putative beneficial role of high dietary vitamin K-1 (phylloquinone) on BMD and the possibility of interactive benefits with vitamin D were studied in a 2-year double-blind, placebo-controlled trial in healthy Scottish women: >= 60 years of age.Materials and Methods: Healthy, nonosteoporotic women (n = 244) were randomized to receive either (1) placebo, (2) 200 mu g/day vitamin K1, (3) 10 mu g (400 IU) vitamin D-3 Plus 1000 mg calcium/day, or (4) combined vitamins K, and D3 plus calcium. Baseline and 6-month measurements included DXA bone mineral scans of the hip and wrist, markers of bone turnover, and vitamin status. Supplementation effects were tested using multivariate general linear modeling, with full adjustment for baseline and potential confounding variables.Results: Significant bone mineral loss was seen only at the mid-distal radius but with no significant difference between groups. However, women who took combined vitamin K and vitamin D plus calcium showed a significant and sustained increase in both BMD and BMC at the site of the ultradistal radius. Serum status indicators responded significantly to respective supplementation with vitamins K and D. Over 2 years, serum vitamin K, increased by 157% (p < 0.001), the percentage of undercarboxylated osteocalcin (%GluOC) decreased by 51% (p < 0.001), serum 25-hydroxyvitamin D [25(OH)D] increased by 17% (p < 0.001), and PTH decreased by 11% (p = 0.049).Conclusions: These results provide evidence of a modest synergy in healthy older women from nutritionally relevant intakes of vitamin K, together with supplements of calcium plus moderate vitamin D3 to enhance BMC at the ultradistal radius, a site consisting of principally trabecular bone. The substantial increase in,gamma-carboxylation of osteocalcin by vitamin K may have long-term benefits and is potentially achievable by increased dietary intakes of vitamin K rather than by supplementation.