Celia Rodríguez-Olleros Rodríguez, Manuel Díaz Curiel
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引用次数: 0
摘要
尽管维生素 K 因其在凝血级联过程中的重要性而闻名,但它还有其他功能。它是骨骼健康所必需的维生素,参与许多与骨骼有关的蛋白质的羧化,调节成骨标志物的基因转录,并调节骨骼的重吸收。维生素 K 缺乏症并不少见,因为矿藏稀少,且依赖于膳食补充和吸收。许多患者服用的维生素 K 拮抗剂口服抗凝剂也会导致维生素 K 缺乏。大多数研究发现,血清 K1 浓度低、羧化不足的骨钙素(ucOC)水平高、膳食中 K1 和 K2 摄入量低与骨折风险较高和 BMD 较低有关。探讨维生素 K 补充剂与骨折风险之间关系的研究也发现,维生素 K 补充剂可降低骨折风险,但需要进行高质量的研究,将骨折作为主要终点进行评估。使用非维生素 K 拮抗剂口服抗凝剂而不是华法林可降低骨折风险,这一点也值得关注,但现有证据再次提供了不同的结果。由于证据稀少且有限,包括得出不同结论的低质量研究,因此无法就这一主题得出可靠的结论,尤其是关于维生素 K 补充剂的使用。
Vitamin K and Bone Health: A Review on the Effects of Vitamin K Deficiency and Supplementation and the Effect of Non-Vitamin K Antagonist Oral Anticoagulants on Different Bone Parameters.
Although known for its importance in the coagulation cascade, vitamin K has other functions. It is an essential vitamin for bone health, taking part in the carboxylation of many bone-related proteins, regulating genetic transcription of osteoblastic markers, and regulating bone reabsorption. Vitamin K deficiency is not uncommon, as deposits are scarce and dependent upon dietary supplementation and absorption. Vitamin K antagonist oral anticoagulants, which are prescribed to many patients, also induce vitamin K deficiency. Most studies find that low serum K1 concentrations, high levels of undercarboxylated osteocalcin (ucOC), and low dietary intake of both K1 and K2 are associated with a higher risk of fracture and lower BMD. Studies exploring the relationship between vitamin K supplementation and fracture risk also find that the risk of fracture is reduced with supplements, but high quality studies designed to evaluate fracture as its primary endpoint are needed. The reduction in risk of fracture with the use of non-vitamin K antagonist oral anticoagulants instead of warfarin is also of interest although once again, the available evidence offers disparate results. The scarce and limited evidence, including low quality studies reaching disparate conclusions, makes it impossible to extract solid conclusions on this topic, especially concerning the use of vitamin K supplements.