Low vitamin K status in adults with cystic fibrosis is associated with reduced body mass index, insulin secretion, and increased pseudomonal colonization.

IF 2.4 4区 医学 Q3 NUTRITION & DIETETICS
Cindy Bergeron, Kathryn J Potter, Valérie Boudreau, Bouchra Ouliass, Anne Bonhoure, Julie Lacombe, Marjolaine Mailhot, Annick Lavoie, Mathieu Ferron, Guylaine Ferland, Rémi Rabasa-Lhoret
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Abstract

Patients with cystic fibrosis (CF) are at high risk of fat-soluble vitamin deficiencies, even with supplementation. The contribution of a suboptimal vitamin K status to respiratory and endocrine pathophysiology in CF has been inadequately characterized. This is a cross-sectional study in adult CF patients (≥18 years old) from the Montreal Cystic Fibrosis Cohort. Vitamin K1 (VK1) was measured with high-performance liquid chromatography, using fasted serum samples collected during an oral glucose tolerance test (OGTT: 2 h with plasma glucose and insulin every 30 min) (n = 168). Patients were categorized according to VK1 status (suboptimal defined as <0.30 nmol/L). Suboptimal VK1 levels were observed in 66% of patients. Patients with a suboptimal VK1 status have a higher risk of colonization with Pseudomonas aeruginosa (p = 0.001), have lower body mass index (BMI) (p = 0.003), and were more likely to have exocrine pancreatic insufficiency (p = 0.002). Using an established threshold for VK1, we did show significantly reduced OGTT-derived measures of insulin secretion in patients with a VK1 status below 0.30 nmol/L (first- and second-phase area under the curve (AUC)INS/GLU (p = 0.002 and p = 0.006), AUCINS (p = 0.012) and AUCINS/GLU (p = 0.004)). Subclinical vitamin K deficiency is more common than other fat-soluble vitamin deficiencies in patients with CF. We demonstrate an association between a suboptimal VK1 status and measures of insulin secretion. We highlight the potential associations of mild vitamin K deficiency with pseudomonal colonization and lower BMI, although these need to be validated in prospective studies.

成人囊性纤维化患者维生素K水平低与体重指数降低、胰岛素分泌和假单胞菌定植增加有关。
囊性纤维化(CF)患者脂溶性维生素缺乏症的风险很高,即使补充了维生素。在CF中,亚理想的维生素K状态对呼吸和内分泌病理生理的贡献尚未得到充分的表征。这是来自蒙特利尔囊性纤维化队列的成年CF患者(≥18岁)的横断面研究。采用高效液相色谱法测定维生素K1 (VK1),采用口服葡萄糖耐量试验(OGTT: 2 h,每30 min一次血浆葡萄糖和胰岛素)中采集的空腹血清样品(n = 168)。患者根据VK1状态(次优定义为铜绿假单胞菌(p = 0.001))、较低的身体质量指数(BMI) (p = 0.003)和更容易发生外分泌胰腺功能不全(p = 0.002)进行分类。使用既定的VK1阈值,我们确实显示了VK1状态低于0.30 nmol/L的患者(第一和第二阶段曲线下面积(AUC)INS/GLU (p = 0.002和p = 0.006), AUCINS (p = 0.012)和AUCINS/GLU (p = 0.004))的ogtt衍生的胰岛素分泌测量显着降低。在CF患者中,亚临床维生素K缺乏症比其他脂溶性维生素缺乏症更常见。我们证明了亚理想的VK1状态与胰岛素分泌之间的关联。我们强调轻度维生素K缺乏与假单胞菌定植和较低BMI之间的潜在关联,尽管这些需要在前瞻性研究中得到验证。
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来源期刊
CiteScore
6.50
自引率
2.90%
发文量
113
审稿时长
4-8 weeks
期刊介绍: Applied Physiology, Nutrition, and Metabolism publishes original research articles, reviews, and commentaries, focussing on the application of physiology, nutrition, and metabolism to the study of human health, physical activity, and fitness. The published research, reviews, and symposia will be of interest to exercise physiologists, physical fitness and exercise rehabilitation specialists, public health and health care professionals, as well as basic and applied physiologists, nutritionists, and biochemists.
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