Nicolaidou Polyxeni, Stavrinadis Ilias, Loukou Ioanna, Papadopoulou Anna, Georgouli Helen, Douros Konstantinos, Priftis Kostas N, Gourgiotis Dimitrios, Matsinos Yiannis G, Doudounakis Stavros
Third Department of Pediatrics, Athens University Medical School, University General Hospital Attikon, Athens, Greece.
Eur J Pediatr. 2006 Aug;165(8):540-5. doi: 10.1007/s00431-006-0132-1. Epub 2006 Apr 19.
Impaired vitamin K status in cystic fibrosis (CF) has been considered as a newly emerged pathogenetic factor for reduced bone mineral density (BMD).
Our aim was to evaluate the effectiveness of vitamin K supplementation in managing bone formation abnormalities in children and adolescents with CF.
The statuses of vitamins K and D in relation to biochemical markers of bone metabolism and BMD were examined in 20 CF children receiving vitamin D supplements but not vitamin K supplements. Laboratory tests were carried out at the beginning of the study period and after 1 year of vitamin K supplementation (10 mg single oral dose/week) and the results were compared; the results were also compared with those of 25 healthy controls.
Ten of the CF patients had BMD z-score<or=2.5 (n=5) or between -1 and -2.5 (n=5). Biochemical tests on patients before vitamin K supplementation revealed that the levels of osteoblastic activity markers, namely, bone alkaline phosphatase (BAP), serum osteocalcin (Gla-OC), serum carboxy-terminal propeptide of type I procollagen (PICP) and serum amino-terminal propeptide of type I procollagen (PINP), were significantly reduced compared with those of the controls. These patients had also lower 25-hydroxy-vitamin D (25(OH)D) and vitamin K serum levels, higher undercaboxylated osteocalcin (Glu-OC) and parathormone (PTH) levels and a higher calcium to creatinine ratio (Ca/Cr) than the controls. Vitamin K intake was associated with an increase in Gla-OC, PINP, PICP levels and a decrease in Glu-OC levels. PTH levels were lower after vitamin K supplementation without any difference in BMD z-scores.
Our data indicate that vitamin K supplementation may have a beneficial role in bone health in CF children.
囊性纤维化（CF）患者维生素K状态受损被认为是骨矿物质密度（BMD）降低的一个新出现的致病因素。
我们的目的是评估补充维生素K对治疗CF儿童和青少年骨形成异常的有效性。
对20名接受维生素D补充剂但未补充维生素K的CF儿童，检测维生素K和D的状态与骨代谢生化标志物及BMD的关系。在研究期开始时以及补充维生素K（每周单次口服剂量10毫克）1年后进行实验室检测，并比较结果；还将结果与25名健康对照者的结果进行比较。
10名CF患者的BMD z评分≤ -2.5（n = 5）或在-1至-2.5之间（n = 5）。补充维生素K前对患者的生化检测显示，与对照组相比，成骨细胞活性标志物，即骨碱性磷酸酶（BAP）、血清骨钙素（Gla-OC）、血清I型前胶原羧基末端前肽（PICP）和血清I型前胶原氨基末端前肽（PINP）的水平显著降低。这些患者的25-羟基维生素D（25(OH)D）和维生素K血清水平也较低，未羧化骨钙素（Glu-OC）和甲状旁腺激素（PTH）水平较高，钙肌酐比值（Ca/Cr）高于对照组。维生素K摄入与Gla-OC、PINP、PICP水平升高和Glu-OC水平降低有关。补充维生素K后PTH水平降低，BMD z评分无差异。
我们的数据表明，补充维生素K可能对CF儿童的骨骼健康有益。
