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甲萘醌(维生素K2)治疗对神经性厌食症患者骨质流失的影响。

Effect of menatetrenone (vitamin K2) treatment on bone loss in patients with anorexia nervosa.

作者信息

Iketani Toshiya, Kiriike Nobuo, Stein B, Nagao Kouji, Nagata Toshihiko, Minamikawa Naomitsu, Shidao Atsushi, Fukuhara Hidehiro

机构信息

Department of Neuropsychiatry, Osaka City University Medical School, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

出版信息

Psychiatry Res. 2003 Mar 25;117(3):259-69. doi: 10.1016/s0165-1781(03)00024-6.

Abstract

Osteoporosis is a common complication of anorexia nervosa (AN). Although weight recovery and resumption of menses are important goals in AN treatment, they are often achieved only after a prolonged period of recovery. Therefore, it becomes important to find therapies with the potential to prevent further decreases in bone mineral density (BMD). We conducted a non-randomized study of the effects of menatetrenone (vitamin K2) on bone loss in patients with AN. Lumbar BMD was longitudinally measured by Dual Energy X-ray Absorptiometry (DXA) in 10 patients with AN who chose to receive menatetrenone treatment (MED+ group) and 11 patients who did not (MED- group). During the mean 0.9-year follow-up period, the BMD of the lumbar vertebrae of the MED+ group decreased significantly less than that of the MED- group (-2.8% and -6.9%, respectively). Among bone metabolism markers, gamma-carboxyglutamic acid osteocalcin significantly increased (128.6% and 28.3%, respectively) and urine deoxypyridinoline significantly decreased (-44.5% and -13.7%, respectively) more in the MED+ group than in the MED- group. These differences in BMD and bone metabolism markers may be attributable to menatetrenone treatment. The results suggest that menatetrenone may be beneficial in the prevention of bone loss in patients with AN. Randomized placebo-controlled studies are needed to confirm these findings.

摘要

骨质疏松症是神经性厌食症(AN)的常见并发症。尽管体重恢复和月经复潮是AN治疗的重要目标,但往往需要经过较长时间的康复才能实现。因此,寻找有可能预防骨矿物质密度(BMD)进一步下降的治疗方法变得很重要。我们进行了一项关于甲萘醌(维生素K2)对AN患者骨质流失影响的非随机研究。通过双能X线吸收法(DXA)对10例选择接受甲萘醌治疗的AN患者(MED+组)和11例未接受治疗的患者(MED-组)进行腰椎BMD的纵向测量。在平均0.9年的随访期内,MED+组腰椎椎体的BMD下降幅度明显小于MED-组(分别为-2.8%和-6.9%)。在骨代谢标志物中,MED+组的γ-羧基谷氨酸骨钙素显著升高(分别为128.6%和28.3%),尿脱氧吡啶啉显著降低(分别为-44.5%和-13.7%),且变化幅度均大于MED-组。BMD和骨代谢标志物的这些差异可能归因于甲萘醌治疗。结果表明,甲萘醌可能有助于预防AN患者的骨质流失。需要进行随机安慰剂对照研究来证实这些发现。

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