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克罗恩病患者的维生素K状态及其与骨转换的关系。

Vitamin K status in patients with Crohn's disease and relationship to bone turnover.

作者信息

Duggan Paula, O'Brien Maria, Kiely Mairead, McCarthy Jane, Shanahan Fergus, Cashman Kevin D

机构信息

Department of Food and Nutritional Sciences, and Alimentary Pharmabiotic Centre, University College, Cork, Ireland.

出版信息

Am J Gastroenterol. 2004 Nov;99(11):2178-85. doi: 10.1111/j.1572-0241.2004.40071.x.

DOI:10.1111/j.1572-0241.2004.40071.x
PMID:15555000
Abstract

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.

摘要

背景

克罗恩病(CD)患者中骨质减少的患病率很高。有证据表明,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

比较目前处于缓解期的CD患者与年龄和性别匹配的对照组维生素K的摄入量和状态,并进一步研究这些患者维生素K状态与骨转换之间的关系。

对象

分别从科克大学医院和科克市地区招募了CD患者(n = 44;平均年龄:36.9岁)和匹配的对照组(n = 44)。

方法

分析血液中总骨钙素和未羧化(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计维生素K1摄入量。

结果

CD患者维生素K1摄入量往往低于对照组(分别为平均(标准差),117(82)对148(80)μg/d;p = 0.059)。CD患者的Glu和NTx浓度高于对照组(分别为平均(标准差),5.1(3.1)对3.9(2.1)ng/ml;Glu的p = 0.03;分别为49(41)对25.8(19.5)nM BCE/mmol肌酐,NTx的p = 0.001)。在CD患者中,即使在控制年龄、性别、维生素D状态、钙摄入量和使用皮质类固醇后,Glu与NTx仍显著相关(r = 0.488;p < 0.001)。

结论

CD患者的维生素K状态低于健康对照组。此外,CD患者的骨吸收速率与维生素K状态呈负相关,表明它可能是CD相关骨质减少的另一个病因因素。

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