维生素D、K2联合干预对早产儿童骨代谢的影响OA

Objective To investigate effect and mechanism of combined intervention of vitamin D(VD)and vitamin K2(VK2)on bone metabolism in preterm infants.Methods One hundred and twenty preterm infants who were born in our hospital from September 2022 to June 2023 were selected as study subjects.They were categorized into low-risk preterm infant group and high-risk preterm infant group according to gestational week and birth weight of the infant,then they were divided into VD conventional treatment group(conventional treatment group)and VD and VK2 combined intervention group(intervention group)according to treatment method(in each group,n=60).Bone metabolism markers{25-hydroxyvitamin D3[25-(OH)-D3],VK2,bone alkaline phosphatase(BALP)and insulin-like growth factor-1(IGF-1)},ultrasonic bone mineral density indexes[Z-score and speed of sound(SOS)],and nutritional indexes(height and head circumference)]were compared between the two groups before intervention and at 6 months and 12 months of corrected ages after intervention in t-test.Pearson correlation analysis was used to analyze correlations between 25-(OH)-D3,VK2 and bone metabolic markers.Results At 6 months and 12 months of corrected ages after intervention,the serum levels of 25-(OH)-D3,VK2,IGF-1,bone density Z-score and SOS,and height and weight of the low-risk premature infants in the intervention group were significantly higher than those low-risk premature infants in the conventional treatment group(at 6 months of corrected age:t=5.039,4.623,2.450,3.368,6.913,4.995 and 2.106 respectively,all P<0.05;at 12 months of corrected age:t=8.437,2.969,3.004,4.106,4.523,3.395 and 3.410 respectively,all P<0.05).Also,at 6 months and 12 months of corrected age after intervention,the serum levels of 25-(OH)-D3,VK2,IGF-1,bone density Z-score and SOS,and height and weight of the high-risk premature infants in the intervention group were significantly higher than those high-risk premature infants in the conventional treatment group(at 6 months of corrected age:t=5.240,7.703,4.584,3.171,5.559,5.349 and 7.434 respectively,all P<0.05;at 12 months of corrected age:t=4.861,6.961,7.928,6.463,5.056,4.795 and 4.482 respectively,all P<0.05).While at 6 months and 12 months of corrected age after intervention,the serum levels of BLAP of both low-risk premature infants and high-risk premature infants in the intervention group were significantly higher than those low-risk premature infants and high-risk premature infants in the conventional treatment group(for the low-risk group:t=7.791 and 5.116 respectively,both P<0.05;for the high-risk group:t=3.516 and 4.568 respectively,both P<0.05).Pearson correlation analysis shown that 25-(OH)-D3 and VK2 were significantly negatively correlated with BALP(r=-0.479 and-0.624 respectively,both P<0.05),while they were positively correlated with IGF-1(r=0.570 and 0.672 respectively,both P<0.05).Conclusion The combined intervention of VD and VK2 is conducive to elevate serum levels of 25-(OH)-D3 and VK2,improve bone metabolism,enhance bone density,and promote growth and development of the premature infants.