Park Ji Na, Lee Ji Sun, Noh Min Young, Sung Mi-Kyung
Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea.
Department of Nutrition, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea.
Clin Nutr Res. 2015 Oct;4(4):235-41. doi: 10.7762/cnr.2015.4.4.235. Epub 2015 Oct 31.
This study aimed to explore the correlation between usual vitamin K intake and response to anticoagulant therapy among patients under warfarin therapy. We conducted a retrospective survey of patients (n = 50) on continuous warfarin therapy. Clinical information and laboratory parameters were sourced from medical records. Anticoagulant effect was evaluated by using the percent time in therapeutic range (TTR) and the coefficient of variation (CV) of International normalized ratio (INR). Dietary vitamin K intake was assessed using a semi-quantitative food frequency questionnaire that has been developed for the purpose of assessing dietary intake of vitamin K. A total of 50 patients aged between 21 and 87 years were included in the study. The mean vitamin K intake was 262.8 ± 165.2 µg/day. Study subjects were divided into tertiles according to their usual vitamin K intake. The proportion of men was significantly higher in second and third tertile than first tertile (p = 0.028). The mean percent TTR was 38.4 ± 28.4% and CV of INR was 31.8 ± 11.8%. Long-term warfarin therapy group (≥ 3 years) had a higher percentage of TTR as compared to the control group (< 3 years) (p = 0.046). No statistically significant correlation was found between usual vitamin K intake and percent TTR (p > 0.05). In conclusion, no significant association was observed between usual vitamin K intake and anticoagulant effects. Further studies are required to consider inter-individual variability of vitamin K intake. Development of assessment tools to measure inter-individual variability of vitamin K intake might be helpful.
本研究旨在探讨接受华法林治疗的患者中，日常维生素K摄入量与抗凝治疗反应之间的相关性。我们对50例接受持续华法林治疗的患者进行了回顾性调查。临床信息和实验室参数均来自病历。通过治疗范围内时间百分比（TTR）和国际标准化比值（INR）的变异系数（CV）来评估抗凝效果。使用为评估维生素K膳食摄入量而开发的半定量食物频率问卷来评估膳食维生素K摄入量。共有50例年龄在21至87岁之间的患者纳入本研究。维生素K的平均摄入量为262.8±165.2μg/天。研究对象根据其日常维生素K摄入量分为三分位数。第二和第三三分位数中的男性比例显著高于第一三分位数（p = 0.028）。平均TTR百分比为38.4±28.4%，INR的CV为31.8±11.8%。与对照组（<3年）相比，长期华法林治疗组（≥3年）的TTR百分比更高（p = 0.046）。日常维生素K摄入量与TTR百分比之间未发现统计学上的显著相关性（p>0.05）。总之，未观察到日常维生素K摄入量与抗凝效果之间存在显著关联。需要进一步研究考虑维生素K摄入量的个体间变异性。开发测量维生素K摄入量个体间变异性的评估工具可能会有所帮助。
