Medical Department, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
Transplantation. 2010 Feb 27;89(4):458-64. doi: 10.1097/TP.0b013e3181c46b69.
Osteoporosis is a problem after transplantation. Studies since the last year indicate that vitamin K plays a role in optimal bone health. The aim of this randomized, double blind, prospective longitudinal study was to investigate the effect of a dietary supplement with vitamin K2 (180 microg menakinon-7) on bone mass, the first year after lung and heart transplantation.
After preoperative baseline investigation of bone mass and bone-related biochemistry, 35 lung and 59 heart recipients were postoperatively randomized to vitamin K2 or placebo and reinvestigated the following year.
In all recipients, 1 year after solid organ transplantation, the difference between vitamin K2 and placebo for the lumbar spine (L2-L4) bone mineral density (BMD) was 0.028 (SE 0.014) g/cm(2), P=0.055 and for L2 to L4 bone mineral content was 1.33 (SE 1.91) g/cm(2) (P=0.5). In lung recipients separately, the difference for bone mineral content was 3.39 g (SE 1.65), P=0.048 and in heart recipients 0.45 (SE 0.02) g, P=0.9 after controlling for baseline measures. In a forward stepwise linear regression analysis fitted to model differences in the L2 to L4 BMD, controlled for possible confounding variables (including use of bisphosphonate), and the only significant predictors were organ (B=-0.065 g/cm(2), P<0.001) and vitamin K2 (B=0.034 g/cm(2), P=0.019). Insufficient vitamin D status was common, and the parathyroid hormone was highest in the K2 group indicating a higher need for vitamin D.
One year of vitamin K2 supplement suggest a favorable effect on lumbar spine BMD with different response in lung and heart recipients. Vitamin D status should receive more attention.
骨质疏松症是移植后的一个问题。去年以来的研究表明，维生素 K 在骨骼健康中发挥作用。本项随机、双盲、前瞻性纵向研究旨在探讨维生素 K2（180 微克 menakinon-7）膳食补充剂对肺和心脏移植后第一年骨量的影响。
在术前进行骨量和骨相关生物化学基础检查后，35 名肺移植受者和 59 名心脏移植受者术后随机分为维生素 K2 组或安慰剂组，并在次年再次进行检查。
所有受者在实体器官移植后 1 年，维生素 K2 组与安慰剂组腰椎（L2-L4）骨密度（BMD）的差异为 0.028（SE 0.014）g/cm2，P=0.055，L2 到 L4 骨矿物质含量的差异为 1.33（SE 1.91）g/cm2（P=0.5）。单独在肺移植受者中，骨矿物质含量的差异为 3.39 克（SE 1.65），P=0.048，在心脏移植受者中为 0.45 克（SE 0.02），P=0.9，在控制基线测量值后。在正向逐步线性回归分析中，拟合到 L2 到 L4 BMD 的差异模型，控制了可能的混杂变量（包括使用双膦酸盐），唯一显著的预测因子是器官（B=-0.065 g/cm2，P<0.001）和维生素 K2（B=0.034 g/cm2，P=0.019）。维生素 D 状态不足很常见，甲状旁腺激素在 K2 组中最高，表明对维生素 D 的需求更高。
一年的维生素 K2 补充剂对腰椎 BMD 有良好的影响，肺和心脏受者的反应不同。维生素 D 状态应受到更多关注。
