背景:维生素K是人体必需的脂溶性维生素及其功能,如促进血液凝固,骨骼健康和预防动脉粥样硬化,引起了越来越多的关注。然而,目前尚无公认的指标和相应的参考范围来评估不同人群的维生素K状况。本研究旨在建立我国健康育龄妇女维生素K评价指标的参考范围。
方法:本研究的人群样本来自2015-2017年中国成人慢性病与营养监测(CACDNS)。使用一系列严格的纳入和排除标准,共纳入631名育龄妇女(18-49岁)。采用液相色谱-串联质谱法(LC-MS/MS)检测血清中VK1、MK-4和MK-7的浓度。其他常用的评价维生素K营养状况的指标,包括羧化不足的骨钙蛋白(ucOC),骨钙蛋白(OC),基质Gla蛋白(MGP),脱磷酸化的低烷氧基化MGP(dp-ucMGP)和维生素K缺乏II(PIVKA-II)诱导的蛋白质,采用酶联免疫吸附试验(ELISA)进行检测。通过计算参考人群中维生素K评价指标的2.5%~97.5%区间,得到参考范围。
结果:血清中VK1,MK-4和MK-7的参考范围为0.21-3.07ng/mL,0.02-0.24ng/mL和0.12-3.54ng/mL,分别。ucOC的参考范围,%ucOC,dp-ucMGP和PIVKA-II为1.09-2.51ng/mL,5.80-22.78%,2.69-5.88ng/mL和3.98-8.40ng/mL,分别。可用于评估亚临床维生素K缺乏的临界值如下:VK1<0.21ng/mL,MK-7<0.12ng/mL,ucOC>2.51ng/mL,%ucOC>22.78%,dp-ucMGP>5.88ng/mL,PIVKA-II>8.40ng/mL。
结论:本研究建立的健康育龄妇女VK1、MK-4、MK-7和维生素K相关指标的参考范围可用于评估该人群的营养和健康状况。
BACKGROUND: Vitamin K is an essential fat-soluble vitamin for the human body and its functions, such as promoting blood coagulation, bone health and preventing atherosclerosis, have attracted increasing attention. However, there is no recognized indicator and corresponding reference range for evaluating vitamin K status of different populations at present. The aim of this study is to establish a reference range for vitamin K evaluating indicators in healthy women of childbearing age in
China.
METHODS: The population sample in this study was from the Chinese Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015-2017. A total of 631 healthy women of childbearing age (18-49 years) were included using a series of strict inclusion and exclusion criteria. The concentrations of VK1, MK-4 and MK-7 in serum were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The other commonly-reported indicators evaluating vitamin K nutritional status, including undercarboxylated osteocalcin (ucOC), osteocalcin (OC), matrix Gla protein (MGP), desphosphorylated undercaboxylated MGP (dp-ucMGP) and protein induced by vitamin K absence II (PIVKA-II), were measured by enzyme-linked immunosorbent assay (ELISA). The reference range was obtained by calculating the 2.5% to 97.5% interval of the vitamin K evaluating indicators in the reference population.
RESULTS: The reference ranges of VK1, MK-4 and MK-7 in serum were 0.21-3.07 ng/mL, 0.02-0.24 ng/mL and 0.12-3.54 ng/mL, respectively. The reference ranges of ucOC, %ucOC, dp-ucMGP and PIVKA-II were 1.09-2.51 ng/mL, 5.80-22.78%, 2.69-5.88 ng/mL and 3.98-8.40 ng/mL, respectively. The cut-off values that can be used to evaluate subclinical vitamin K deficiency were as follows: VK1 < 0.21 ng/mL, MK-7 < 0.12 ng/mL, ucOC > 2.51 ng/mL, %ucOC > 22.78%, dp-ucMGP > 5.88 ng/mL and PIVKA-II > 8.40 ng/mL.
CONCLUSIONS: The reference range of VK1, MK-4, MK-7 and vitamin K-related indicators for healthy women of childbearing age established in this study could be used to assess the nutritional and health status of this population.