A study of osteoporosis on severe motor and intellectual disabilities from the elemental side -the relation between the tube feeding and vitamin K-

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  • Sakai Tomoko
    Tokyo metropolitan center for persons with developmental/multiple disabilities, Kouto-ku, Tokyo
  • Kaga Makiko
    Tokyo metropolitan center for persons with developmental/multiple disabilities, Kouto-ku, Tokyo
  • Iwasaki Yuji
    Tokyo metropolitan center for persons with developmental/multiple disabilities, Kouto-ku, Tokyo
  • Masuyama Tatsuo
    Tokyo metropolitan center for persons with developmental/multiple disabilities, Kouto-ku, Tokyo

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Other Title
  • 重症心身障害児（者）における栄養の観点からの骨粗鬆症の検討　−経管栄養とビタミンKの関係−
  • 重症心身障害児(者)における栄養の観点からの骨粗鬆症の検討 : 経管栄養とビタミンKの関係
  • ジュウショウ シンシン ショウガイジ(モノ)ニ オケル エイヨウ ノ カンテン カラ ノ コツソショウショウ ノ ケントウ : ケイカン エイヨウ ト ビタミン K ノ カンケイ

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Abstract

This study aimed to determine the extent and pathology of bone porosis in patients with severe motor and intellectual disabilities (SMID). In total, 53 patients (26 male, 27 female; mean age, 33.2 years) with SMID in our center underwent quantitative ultrasound for assessment of bone quality and bone metabolism markers (bone alkaline phosphatase [BAP], tartrate-resistant acid phosphatase [TRACP], and undercarboxylated osteocalcin [ucOC]). With regard to bone mineral density, the average T-score of the patients was -3.85 SD and the average Z-score was -3.60 SD. Their serum BAP and TRACP 4 levels were not elevated, indicating normal skeletal turnover. Serum ucOC level was elevated in33.3% of the patients, reflecting a deficiency of vitamin K2. All patients were divided into two groups, namely tube group (treated with tube feeding) and non-tube group (treated without tube feeding). About 85.8% of the patients with elevated serum ucOC level belonged to the tube group. The serum ucOC level of patients in the tube group was significantly higher than that of patients in the non-tube group. A high prevalence of vitamin K2 deficiency was found in patients in the tube group. Similarly, the Z-score of patients in the tube group was significantly lower than that of patients in the non-tube group. Our results suggest that vitamin K2 supplementation along with monitoring of serum ucOC levels could help reduce the risk of osteoporosis in patients with SMID.

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