High Prevalence of Hypovitaminosis D and K in Patients with Hip Fracture

髖部骨折病患維生素D與K不足之高盛行率

Tetsuo Nakano ； Naoko Tsugawa ； Akiko Kuwabara ； Maya Kamao ； Kiyoshi Tanaka ； Toshio Okano

《Asia Pacific Journal of Clinical Nutrition》 20卷1期 (2011/03) Pp. 56-61

https://doi.org/10.6133/apjcn.2011.20.1.09

摘要

過去研究顯示髖部骨折與維生素D及維生素K不足有關，但較少研究將兩者共同納入探討。本研究之對象為99位有髖部骨折的病患，檢測其整體營養及體內維生素D與維生素K的狀態。女性患者血清25-羥化維生素D（25OH-D）濃度平均只有約9 ng/mL，顯示女性患者有嚴重維生素D缺乏。男女性患者血清中副甲狀腺素及男性血清25OH-D平均濃度與對照組皆沒有顯著差異。然而在男女性髖部骨折患者，其血漿維生素K1及維生素K2濃度都顯著較對照組低。以羅吉斯回歸分析發現，體內白蛋白、維生素K1及25OH-D濃度皆為骨折發生風險之顯著獨立預測因子，具呈負相關。最後以主成份分析進行臨床參數統整後，獲得三項代表參數，分別代表整體營養狀態、維生素D營養狀態及維生素K狀態。總而言之，本研究顯示髖部骨折患者易出現維生素D及維生素K缺乏，且與整體營養不良無關。

關鍵字

維生素D缺乏 ； 維生素K缺乏 ； 髖部骨折病患 ； 整體營養不良 ； 主成分分析

並列摘要

Although hip fracture is considered to be associated with hypovitaminosis D and K, few reports have previously studied both of them. We have studied the vitamin D- and K-status as well as the general nutritional status in ninety-nine patients with hip fracture. Mean serum concentration of 25hydroxy-vitamin D (25OH-D) in female fractured patients was only approximately 9 ng/mL, suggesting severe vitamin D deficiency. There was no significant difference between the two groups in serum concentration of intact parathyroid hormone in both genders and serum 25OH-D levels in the male subjects. Plasma concentrations of phylloquinone (vitamin K1; PK) and menaquinone-7 (MK-7) were significantly lower in the fractured group than in the control group in both genders. Logistic regression analysis indicated that circulating concentrations of albumin, PK and 25OH-D were the significant and independent determinants of fracture risk, with their higher concentrations associated with decreased fracture risk. Finally, principal component analysis (PCA) was performed to summarize the clinical parameters into smaller numbers of independent components. Three components were obtained, each representing the overall nutritional status, the vitamin D status, and the vitamin K status. In conclusion, our study has shown that patients with hip fracture have vitamin D and K deficiency independent of general malnutrition.

並列關鍵字

hypovitaminosis D ； hypovitaminosis K ； patients with hip fracture ； general malnutrition ； principal component analysis