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Abstract：
Protein induced by vitamin K (VK) absence-II (PIVKA-II) is a sensitive marker for diagnosing hepatoma but is occasionally detected in patients without hepatoma Here, the clinical significance of serum PIVKA-II levels in patients who were not administered warfarin and did not have hepatoma or liver disease were evaluated. As VK is related to muscle and bone metabolism, PIVKA-II and clinical factors related to bone and muscle were compared. A total of 441 patients with various liver diseases were evaluated. Of these, 236 patients were female. Clinical factors and anthropometric measurements were obtained for each participant during outpatient visits. Among the clinical factors, type I procollagen N-propeptide (P1NP), a low titer of undercarboxylated osteocalcin (ucOC), and 25(OH) vitamin D (VD) were used as bone metabolic markers, and SARC-F and grip strength were used as muscle-related markers. Serum PIVKA-II levels above the upper limit were associated with Child B/C (Child-Pugh score), high titers of total P1NP, and low titers of ucOC in females, and alcohol-related liver disease and low VD in males. The titer of PIVKA-II were associated with immunoglobulin (Ig) A and prothrombin time (PT)-international normalized ratio (INR) in females, and fibrosis-4-4, IgG, total bilirubin, PT-INR, and SARC-F in males. Elevated PIVKA-II levels were associated with abnormal bone physiology in females, weak muscles in males, and severe liver disease in both sexes. Assessing PIVKA-II may assist in evaluating the clinical and bone-muscle metabolic stages in liver disease. Nutrition and supplementation with fat-soluble vitamins, including VK and VD may thus serve as a potential method to alleviate or prevent bone-muscle pathophysiology in patients with liver disease.
摘要：
由维生素K（VK）缺失-II（PIVKA-II）诱导的蛋白质是诊断肝癌的敏感标志物，但偶尔在没有肝癌的患者中检测到。对未服用华法林且未发生肝癌或肝病的患者血清PIVKA-II水平的临床意义进行了评估.由于VK与肌肉和骨骼代谢有关，比较PIVKA-II和与骨骼和肌肉相关的临床因素。共评估了441名患有各种肝病的患者。其中,236例患者为女性。在门诊就诊期间获得每位参与者的临床因素和人体测量值。在临床因素中，I型前胶原N-前肽(P1NP),低羧化骨钙蛋白（ucOC）的低滴度，和25（OH）维生素D（VD）作为骨代谢标志物，和SARC-F和握力被用作肌肉相关的标志物。血清PIVKA-II水平高于上限与ChildB/C（Child-Pugh评分）相关，总P1NP的高滴度，女性的ucOC滴度低，男性与酒精相关的肝病和低VD。PIVKA-II的滴度与女性的免疫球蛋白（Ig）A和凝血酶原时间（PT）-国际标准化比率（INR）相关，和纤维化-4-4，IgG，总胆红素,PT-INR,和男性的SARC-F。PIVKA-II水平升高与女性骨生理异常相关，男性肌肉虚弱，男女都有严重的肝病。评估PIVKA-II可能有助于评估肝病的临床和骨-肌肉代谢阶段。营养和补充脂溶性维生素，因此,包括VK和VD可作为减轻或预防肝病患者骨肌病理生理学的潜在方法。
