1732例儿童血清维生素K_(2)临床分析及其与骨代谢标志物关系的研究

Serum vitamin K_(2) level and its association with bone metabolism markers in 1732 children

目的分析儿童血清维生素K_(2)(vitamin K_(2),VitK_(2))临床特征及其与骨钙素(osteocalcin,OC)、Ⅰ型前胶原氨基端前肽(typeⅠprocollagen amino-terminal peptide,PINP)、Ⅰ型胶原交联羧基末端肽(typeⅠcollagen carboxy-terminal peptide,CTX)的相关性。方法前瞻性选取2020年10月至2021年10月门诊常规体检儿童1732例,测定血清VitK_(2)、25羟维生素D[25-hydroxyvitamin D,25(OH)D]水平,按年龄段分为<1岁组、1~3岁组、>3~6岁组、>6~14岁组,进行血清VitK_(2)相关临床分析。筛选出25(OH)D≥50 nmol/L的儿童共309例,测定血清OC、PINP、CTX水平,分析不同年龄段水平及其与血清VitK_(2)的相关性。结果血清VitK_(2)缺乏率为52.31%(906/1732)。VitK_(2)缺乏组超重/肥胖、生长痛(≥3岁)发生率均高于VitK_(2)正常组(P<0.05);1~3岁组和>6~14岁组血清VitK_(2)缺乏率(P<0.0083)、血清VitK_(2)水平(P<0.05)差异有统计学意义。<1岁组儿童血清CTX水平高于>3~6岁组和>6~14岁组,而<1岁组儿童血清PINP水平低于>3~6岁组和>6~14岁组(P<0.05);<1岁组血清OC水平低于>6~14岁组(P<0.05)。血清VitK_(2)与OC呈正相关(r_(s)=0.347,P<0.01),CTX与PINP呈负相关(r_(s)=-0.317,P<0.01)。结论VitK_(2)缺乏可能与超重/肥胖有关;血清VitK_(2)可影响OC水平进而影响骨骼健康。

Objective To study the level of serum vitamin K_(2)(VitK_(2))and its association with bone metabolism markers osteocalcin(OC),type Ⅰ procollagen amino-terminal peptide(PINP),and type Ⅰ collagen carboxy-terminal peptide(CTX)in children.Methods A prospective analysis was performed on 1732 children who underwent routine physical examination from October 2020 to October 2021.The serum levels of VitK_(2) and 25-hydroxy vitamin D[25(OH)D]were measured.According to age,they were divided into four groups:<1 year,1-3 years group,>3-6 years group,and>6-14 years.A total of 309 children with 25(OH)D≥50 nmol/L were screened out,and serum levels of OC,PINP,and CTX were measured to investigate the correlation of the serum levels of OC,PINP,and CTX with serum VitK_(2) levels in different age groups.Results The prevalence rate of serum VitK_(2) deficiency was 52.31%(906/1732).The VitK_(2) deficiency group had higher prevalence rates of overweight/obesity and growth pain(≥3 years of age)than the normal VitK_(2) group(P<0.05).There were differences in the prevalence rate of serum VitK_(2) deficiency(P<0.0083)and the serum level of VitK_(2)(P<0.05)between the 1-3 years group and the>6-14 years group.The<1 year group had a higher serum level of CTX and a lower serum level of PINP than the>3-6 years group and the>6-14 years group(P<0.05).The<1 year group had a lower serum level of OC than the>6-14 years group(P<0.05).Serum VitK_(2) level was positively correlated with OC level(r_(s)=0.347,P<0.01),and CTX level was negatively correlated with PINP level(r_(s)=-0.317,P<0.01).Conclusions Serum VitK_(2) deficiency may be associated with overweight/obesity. Serum VitK_(2) may affect the level of OC and even bone health.