Abstract：
OBJECTIVE: To investigate whether patients with severe motor and intellectual disability (SMID) have nutritional vitamin D and K insufficiencies and clarify the required vitamin supplementation.
METHODS: This prospective observational study enrolled Japanese adults with SMID receiving institutionalized care who underwent blood sampling between February 2020 and February 2022 during annual medical checkups. Serum vitamin K1 and 25-hydroxy vitamin D (25(OH)D) levels were measured to determine their relationship with serum uncarboxylated osteocalcin (ucOC) levels. Vitamin D and K intake was compared among tube-fed and oral-intake patients with SMID and control participants using corresponding serum levels.
RESULTS: The study included 124 patients with SMID (56 men and 68 women; mean age: 53.0 years) and 20 control participants. Serum 25(OH)D levels were significantly higher in the SMID group than in the control group and the oral intake SMID group than in the tube-fed SMID group. In the tube-fed SMID group, vitamin D intake was lower than the daily recommended intake and correlated with serum 25(OH)D levels. Daily vitamin K intake in the tube-fed group was lower than recommended but not correlated with serum vitamin K levels. Serum ucOC levels were significantly higher in the SMID group than in the control group. Tube feeding was significantly and positively correlated with serum 25(OH)D levels. Serum 25(OH)D levels were not correlated with serum vitamin K1 levels.
CONCLUSIONS: The SMID group had higher ucOC levels than the control group, possibly owing to daily vitamin K and D deficiencies. Vitamin D supplementation is recommended to decrease ucOC levels.
METHODS: This prospective observational study enrolled Japanese adults with SMID receiving institutionalized care who underwent blood sampling between February 2020 and February 2022 during annual medical checkups. Serum vitamin K1 and 25-hydroxy vitamin D (25(OH)D) levels were measured to determine their relationship with serum uncarboxylated osteocalcin (ucOC) levels. Vitamin D and K intake was compared among tube-fed and oral-intake patients with SMID and control participants using corresponding serum levels.
RESULTS: The study included 124 patients with SMID (56 men and 68 women; mean age: 53.0 years) and 20 control participants. Serum 25(OH)D levels were significantly higher in the SMID group than in the control group and the oral intake SMID group than in the tube-fed SMID group. In the tube-fed SMID group, vitamin D intake was lower than the daily recommended intake and correlated with serum 25(OH)D levels. Daily vitamin K intake in the tube-fed group was lower than recommended but not correlated with serum vitamin K levels. Serum ucOC levels were significantly higher in the SMID group than in the control group. Tube feeding was significantly and positively correlated with serum 25(OH)D levels. Serum 25(OH)D levels were not correlated with serum vitamin K1 levels.
CONCLUSIONS: The SMID group had higher ucOC levels than the control group, possibly owing to daily vitamin K and D deficiencies. Vitamin D supplementation is recommended to decrease ucOC levels.
摘要：
目的：调查重度运动和智力残疾（SMID）患者是否存在营养维生素D和K不足，并阐明所需的维生素补充。
方法：这项前瞻性观察性研究招募了接受机构护理的SMID日本成年人，他们在2020年2月至2022年2月的年度体检期间接受了血液采样。测量血清维生素K1和25-羟基维生素D（25（OH）D）水平，以确定它们与血清未羧化骨钙蛋白（ucOC）水平的关系。使用相应的血清水平，比较了管饲和口服SMID患者和对照组参与者的维生素D和K摄入量。
结果：该研究包括124名SMID患者（56名男性和68名女性；平均年龄：53.0岁）和20名对照参与者。SMID组血清25（OH）D水平明显高于对照组，口服SMID组明显高于管饲SMID组。在管式SMID组中，维生素D摄入量低于每日推荐摄入量,且与血清25(OH)D水平相关.管饲组的每日维生素K摄入量低于建议，但与血清维生素K水平无关。SMID组血清ucOC水平明显高于对照组。管饲与血清25(OH)D水平呈显著正相关。血清25（OH）D水平与血清维生素K1水平无关。
结论：SMID组的ucOC水平高于对照组，可能是由于日常维生素K和D缺乏。建议补充维生素D以降低ucOC水平。
方法：这项前瞻性观察性研究招募了接受机构护理的SMID日本成年人，他们在2020年2月至2022年2月的年度体检期间接受了血液采样。测量血清维生素K1和25-羟基维生素D（25（OH）D）水平，以确定它们与血清未羧化骨钙蛋白（ucOC）水平的关系。使用相应的血清水平，比较了管饲和口服SMID患者和对照组参与者的维生素D和K摄入量。
结果：该研究包括124名SMID患者（56名男性和68名女性；平均年龄：53.0岁）和20名对照参与者。SMID组血清25（OH）D水平明显高于对照组，口服SMID组明显高于管饲SMID组。在管式SMID组中，维生素D摄入量低于每日推荐摄入量,且与血清25(OH)D水平相关.管饲组的每日维生素K摄入量低于建议，但与血清维生素K水平无关。SMID组血清ucOC水平明显高于对照组。管饲与血清25(OH)D水平呈显著正相关。血清25（OH）D水平与血清维生素K1水平无关。
结论：SMID组的ucOC水平高于对照组，可能是由于日常维生素K和D缺乏。建议补充维生素D以降低ucOC水平。
