title: Extremes in vitamin K status of bone are related to bone ultrasound properties in children with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Osteopenia is a common complication of juvenile idiopathic arthritis (JIA). In adults, low bone density and increased fracture risk are associated with low vitamin K status of bone. The vitamin K-dependent protein osteocalcin plays an important role in bone metabolism. Its activity depends upon post-translational carboxylation in which vitamin K is an essential co-factor. Hence, vitamin K deficiency leads to under-carboxylated (i.e., inactive) osteocalcin (ucOC). Little is known about the vitamin K status and bone health in children with juvenile idiopathic arthritis (JIA). We studied the vitamin K status of bone and its association with bone mass properties in children with JIA compared to healthy children.
  
  
  METHODS
  We performed a cross sectional study in 55 children with JIA and 54 healthy controls between 6-18 years of age. Bone markers, ultrasound bone mass properties and vitamin K status of bone were determined.
  
  
  RESULTS
  Overall, no differences in vitamin K status of bone were found between the study groups. Among children with JIA, a high ratio of ucOC/cOC indicating low vitamin K status was associated with low bone ultrasound parameters, whereas children with a high vitamin K status had markedly higher bone properties. This association was independent of physical activity, age, gender and BMI.
  
  
  CONCLUSIONS
  These results suggest that vitamin K may be one of multiple risk factors for low bone mass in children with JIA, in addition to other recognized determinants of bone mass. The question remains whether JIA patients would benefit from increased dietary vitamin K intake.
authors.affiliation: Department of Paediatric Immunology, University Medical Centre Utrecht, The Netherlands. m.j.h.vansummeren@umcutrecht.nl
authors.forename: M J H
authors.initials: MJ
authors.lastname: van Summeren
authors.forename: C
authors.initials: C
authors.lastname: Vermeer
authors.forename: R H H
authors.initials: RH
authors.lastname: Engelbert
authors.forename: L J
authors.initials: LJ
authors.lastname: Schurgers
authors.forename: T
authors.initials: T
authors.lastname: Takken
authors.forename: K
authors.initials: K
authors.lastname: Fischer
authors.forename: W
authors.initials: W
authors.lastname: Kuis
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000378:metabolism; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000378:metabolism; D012307:Risk Factors; D014463:Ultrasonography; D014812:Vitamin K / Q000097:blood*; D014813:Vitamin K Deficiency / Q000097:blood / Q000150:complications
chemical_list: D015415:Biomarkers; D015675:Osteocalcin; D014812:Vitamin K