Feng Yunlin, Ruan Yizhe, He Qiang, Zhang Wensong, Wang Li
Nephrology Division, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Nephrology Division, Affiliated Medical School of University of Electronic Science and Technology, Chengdu, China.
Nephrology (Carlton). 2015 Sep;20(9):625-31. doi: 10.1111/nep.12494.
Vitamin K deficiency is known to be common in haemodialysis patients and associates with adverse outcomes in this population, particularly vascular calcification. We aimed to investigate the vitamin K status in a population of Chinese haemodialysis (HD) patients.
We collected demographic and biochemical data from a population of maintenance HD (MHD) patients in our unit and a control group composed of healthy subjects from our outpatient clinic. Fasting serum samples from all subjects were collected for the measurement of known vitamin K-dependent proteins i.e. matrix Gla protein (MGP), osteocalcin (OC) and uncarboxylated osteocalcin (ucOC). We also quantified the fraction of ucOC to total OC (%ucOC). Differences of these parameters between groups were analyzed and risk factors of vitamin K deficiency based on the definition as per %ucOC were investigated.
We enrolled 93 MHD patients as a test group and 93 healthy subjects as a control group. There was no significant difference in MGP between groups (4.0 ± 2.8 pg/mL in MHD vs 4.2 ± 1.2 pg/mL in control; P = 0.676). Mean %ucOC was significantly greater in the MHD patients as compared to control subjects (76.4 ± 20.0% in MHD vs 48.56 ± 15.5%; P < 0.001). Time on dialysis and low-density lipoprotein cholesterol level appeared to be indicators of vitamin K deficiency, with the former being an independent risk factor.
Defining Vitamin K deficiency by %ucOC, suboptimal vitamin K levels appear common in Chinese MHD patients. Time on dialysis and LDL cholesterol level predict vitamin K deficiency.
已知维生素K缺乏在血液透析患者中很常见，并且与该人群的不良结局相关，尤其是血管钙化。我们旨在调查中国血液透析（HD）患者群体中的维生素K状态。
我们收集了本单位维持性血液透析（MHD）患者群体以及由门诊健康受试者组成的对照组的人口统计学和生化数据。采集所有受试者的空腹血清样本，以测量已知的维生素K依赖性蛋白，即基质Gla蛋白（MGP）、骨钙素（OC）和未羧化骨钙素（ucOC）。我们还对ucOC占总OC的比例（%ucOC）进行了量化。分析了两组之间这些参数的差异，并根据%ucOC的定义调查了维生素K缺乏的危险因素。
我们纳入了93例MHD患者作为试验组，93例健康受试者作为对照组。两组之间的MGP无显著差异（MHD组为4.0±2.8 pg/mL，对照组为4.2±1.2 pg/mL；P = 0.676）。与对照组相比，MHD患者的平均%ucOC显著更高（MHD组为76.4± 20.0%，对照组为48.56±15.5%；P < 0.001）。透析时间和低密度脂蛋白胆固醇水平似乎是维生素K缺乏的指标，前者是独立危险因素。
根据%ucOC定义维生素K缺乏，中国MHD患者中维生素K水平欠佳似乎很常见。透析时间和低密度脂蛋白胆固醇水平可预测维生素K缺乏。
