维生素K的膳食和生化指标与男性及女性足跟定量超声的相关性

Association of dietary and biochemical measures of vitamin K with quantitative ultrasound of the heel in men and women.

作者信息

McLean R R, Booth S L, Kiel D P, Broe K E, Gagnon D R, Tucker K L, Cupples L A, Hannan M T

机构信息

National Heart Lung and Blood Institute, National Institutes of Health, USA.

出版信息

Osteoporos Int. 2006;17(4):600-7. doi: 10.1007/s00198-005-0022-9. Epub 2006 Jan 6.

DOI:10.1007/s00198-005-0022-9

PMID:16397819

Abstract

INTRODUCTION

Low vitamin K nutritional status is associated with increased fracture risk but is inconsistently related to bone mineral density (BMD), suggesting that vitamin K may affect components of bone strength not measured by BMD, such as microarchitecture. Quantitative ultrasound (QUS) may assess trabecular orientation, providing information on the mechanical properties of bone and may serve as a potential alternative to BMD for gaining insight to the relation between vitamin K and bone strength. We therefore examined the association of vitamin K nutritional status measured in several different ways with QUS in men and women who participated in the Framingham Osteoporosis Study.

METHODS

From 1996 to 2001, broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the calcaneus (heel) were measured in 583 men and 768 women (mean age 59 years). Vitamin K nutritional status was assessed between 1995 and 1998 by three separate measures: plasma phylloquinone concentration, serum percent undercarboxylated osteocalcin (%ucOC) and dietary vitamin K intake. Multiple linear regression analyses were used to calculate regression coefficients in order to evaluate the associations between both measures of QUS and each measure of vitamin K nutritional status. Regression analyses were conducted separately for subgroups of participants defined by gender, menopause status and current use of estrogen replacement medication.

RESULTS

Among the men, plasma phylloquinone concentration was positively associated with both BUA (P<0.01) and SOS (P=0.02) of the heel. Neither serum %ucOC nor dietary vitamin K intake, however, was associated with QUS measures. Among women, none of the three measures of vitamin K nutritional status were associated with either BUA or SOS, regardless of menopause status or use of estrogen. Although QUS is associated with vitamin K nutritional status in men, the observed relation was not consistent among subgroups of participants.

CONCLUSION

These findings suggest that QUS may not be the best method for elucidating the role of vitamin K on the skeleton.

摘要

引言

维生素K营养状况低下与骨折风险增加相关，但与骨矿物质密度（BMD）的关系并不一致，这表明维生素K可能会影响骨强度中未通过BMD测量的成分，如微观结构。定量超声（QUS）可以评估小梁方向，提供有关骨力学性能的信息，并且可能成为BMD的潜在替代方法，以深入了解维生素K与骨强度之间的关系。因此，我们在参与弗雷明汉骨质疏松研究的男性和女性中，研究了几种不同测量方式所测得的维生素K营养状况与QUS之间的关联。

方法

1996年至2001年，对583名男性和768名女性（平均年龄59岁）测量了跟骨（足跟）的宽带超声衰减（BUA）和声速（SOS）。1995年至1998年期间，通过三种不同的测量方法评估维生素K营养状况：血浆叶绿醌浓度、血清未羧化骨钙素百分比（%ucOC）和膳食维生素K摄入量。采用多元线性回归分析来计算回归系数，以评估QUS的两种测量指标与维生素K营养状况的每种测量指标之间的关联。针对按性别绝经状态和当前雌激素替代药物使用情况定义的参与者亚组分别进行回归分析。

结果

在男性中，血浆叶绿醌浓度与足跟的BUA（P<0.01）和SOS（P=0.02）均呈正相关。然而，血清%ucOC和膳食维生素K摄入量均与QUS测量指标无关。在女性中，无论绝经状态或雌激素使用情况如何，维生素K营养状况的三种测量指标均与BUA或SOS无关。尽管QUS与男性的维生素K营养状况相关，但在参与者亚组中观察到的这种关系并不一致。