PDF(Pubmed)
Abstract：
Nutritional support is essential for patients with severe motor and intellectual disabilities (SMID) to ensure the smooth provision of medical care. These patients often require long-term tube feeding with enteral formulas, potentially leading to deficiencies in vitamins and trace elements. Additionally, frequent antibiotic use for infections often disrupts gut microbiota, inhibiting vitamin K2 production by intestinal bacteria. We assessed the serum protein induced by vitamin K absence or antagonists-II (PIVKA-II) and undercarboxylated osteocalcin (ucOC) levels to assess the vitamin K status in 20 patients with SMID (median age: 44.1 years, 11 men and 9 women) undergoing long-term tube feeding for durations ranging from 3 to 31 years. Thirteen (65%) and nine (45%) patients had elevated PIVKA-II (<40 mAU/mL) and serum ucOC levels (reference value < 4.50 ng/mL), respectively. Dietary vitamin K1 intake did not differ between patients with and without elevated PIVKA-II levels. Vitamin K2 supplementation for 3 months decreased serum PIVKA-II levels near those within the reference range. Approximately half of the patients with SMID on tube feeding had subclinical vitamin K deficiency. Further studies are needed to ascertain if long-term vitamin K2 supplementation effectively prevents vitamin K deficiency-induced hypercoagulation, osteoporosis, and vascular calcification in patients with SMID.
摘要：
营养支持对于患有严重运动和智力残疾（SMID）的患者至关重要，以确保顺利提供医疗服务。这些患者通常需要长期使用肠内配方进行管饲，可能导致维生素和微量元素缺乏。此外,频繁使用抗生素治疗感染通常会破坏肠道微生物群，抑制肠道细菌产生维生素K2。我们评估了维生素K缺乏或拮抗剂II（PIVKA-II）和羧化不足的骨钙蛋白（ucOC）水平诱导的血清蛋白，以评估20例SMID患者的维生素K状态（中位年龄：44.1岁，11名男性和9名女性）接受长期管饲，持续时间为3至31年。13例（65%）和9例（45%）患者PIVKA-II（<40mAU/mL）和血清ucOC水平（参考值<4.50ng/mL）升高，分别。有和没有PIVKA-II水平升高的患者的饮食维生素K1摄入量没有差异。3个月补充维生素K2使血清PIVKA-II水平降低至接近参考范围。接受管饲的SMID患者中约有一半患有亚临床维生素K缺乏症。需要进一步的研究来确定长期补充维生素K2是否能有效预防维生素K缺乏引起的高凝，骨质疏松,SMID患者的血管钙化。
