1 732例儿童血清维生素K2临床分析及其与骨代谢标志物关系的研究

目的 分析儿童血清维生素K₂（vitamin K₂，VitK₂）临床特征及其与骨钙素（osteocalcin，OC）、Ⅰ型前胶原氨基端前肽（type Ⅰ procollagen amino-terminal peptide，PINP）、Ⅰ型胶原交联羧基末端肽（type Ⅰ collagen 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1 732例，测定血清VitK₂、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VitK₂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VitK₂的相关性。 结果 血清VitK₂缺乏率为52.31%（906/1 732）。VitK₂缺乏组超重/肥胖、生长痛（≥3岁）发生率均高于VitK₂正常组（P<0.05）；1~3岁组和>6~14岁组血清VitK₂缺乏率（P<0.0083）、血清VitK₂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VitK₂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 VitK₂缺乏可能与超重/肥胖有关；血清VitK₂可影响OC水平进而影响骨骼健康。

Serum vitamin K2 level and its association with bone metabolism markers in 1 732 children

Objective To study the level of serum vitamin K2 (VitK2) 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 1 732 children who underwent routine physical examination from October 2020 to October 2021. The serum levels of VitK2 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 VitK2 levels in different age groups. Results The prevalence rate of serum VitK2 deficiency was 52.31% (906/1 732). The VitK2 deficiency group had higher prevalence rates of overweight/obesity and growth pain (≥3 years of age) than the normal VitK2 group (P<0.05). There were differences in the prevalence rate of serum VitK2 deficiency (P<0.0083) and the serum level of VitK2 (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 VitK2 level was positively correlated with OC level (rs=0.347, P<0.01), and CTX level was negatively correlated with PINP level (rs=-0.317, P<0.01). Conclusions Serum VitK2 deficiency may be associated with overweight/obesity. Serum VitK2 may affect the level of OC and even bone health.