Abstract
As the life span of patients with cystic fibrosis (CF) has gradually increased, a variety of problems, like osteoporosis, have been recognized. Hypovitaminosis D, hypogonadism, lack of physical activity and chronic inflammation are some of the factors that contribute to the pathogenesis of bone disease in CF patients. Decreased absorption of vitamin K because of pancreatic insufficiency could be another risk factor for osteoporosis. The aim of the study was to determine the implication of vitamin K in the pathogenesis of osteoporosis in CF children and adolescent. We studied 20 patients with CF (ten boys) aged 6 to 7 years old and 25 healthy subjects of similar age and sex. All patients were evaluated before and 1 year after vitamin K supplementation. In all patients and controls serum carboxy-terminal propeptide of procolagen type I (PICP), amino-terminal propeptide of procolagen type I (PINP), bone alkaline phosphatase (sALP), osteocalcin (OC), cross-linked carboxy terminal telopeptide of type 1 collagen (ICTP), vitamin D, parathormone (PTH) and undercarboxylated osteocalcin (GLU-OC) were determined. Urine deoxypyridinoline/creatinine was also determined. Bone density was measured only in the patients using dual-energy x-ray absorptiometry (DEXA). Our results indicated that 55% of CF patients had osteoporosis. The supplemented patients showed: a)increase of bone density (0.789±0.149 than 0.737 ± 0.151, p<0.0001), b) increase of PINP (579.35±275.11microg/l than 341.65±270.77microg/l, p<0.0001) c) increase of PICP (341.30±140.53 microg/l than 290.06±117.64microg/l, p<0.011) d)increase of sALP (51.75±14.94microg/l than 45.28±20.48 microg/l, p<0.024) e)increase of oc (26.22±14.25ng/ml than 15.45±11.62ng/ml, p<0.004) f)decrease of GLU-OC (2.28±3.93ng/ml than 6.60±6.24, p<0.004). According to our results, vitamin K supplementation in CF children and adolescent improves BMD by enhancing osteoblast activity.
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Nicolaidou, P., Georgouli, H., Stavrinadis, I. et al. 142 The Effect of Vitamin K Supplementation on BMD in Children and Adolescent with Cystic Fibrosis. Pediatr Res 58, 379 (2005). https://doi.org/10.1203/00006450-200508000-00171
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DOI: https://doi.org/10.1203/00006450-200508000-00171
