The Canadian Home Total Parenteral Nutrition (HTPN) Registry: vitamin K supplementation and bone mineral density.
BACKGROUND
Vitamin K supplementation improves bone health, and its absence might be associated with low bone mineral density (BMD). The authors aim to assess vitamin K supplementation practices in Canadian home parenteral nutrition (HPN) programs and their relationship with BMD.


METHODS
This is a cross-sectional study of 189 patients from the Canadian HPN registry.


RESULTS
All 189 patients studied received M.V.I.-12, which does not contain vitamin K. Of those, 41.3% were supplemented with 10 mg of intravenous vitamin K (VK+) weekly, whereas the others did not receive vitamin K except via lipid emulsion (VK-). Short bowel syndrome accounted for 69% of VK+ and 46% of VK- patients. On univariate analysis, VK+ patients had substantially lower body mass index (BMI) and received lower bisphosphonate infusion than did VK-patients. There were no statistically significant differences in HPN calcium or lipid content, liver function test results, age, sex, or reason for HPN between the 2 groups. Patients who were VK+ had higher lumbar spine T scores and hip T scores than did VK-patients. General linear modeling analysis, adjusted for BMI, age, PN magnesium, PN phosphate, PN calcium, and bisphosphonate as possible predictors of BMD, showed a trend toward better hip T scores (P = .063) for VK+ patients compared with VK- patients.


CONCLUSIONS
In HPN patients supplemented with vitamin K, the trend toward a better hip BMD compared with no supplementation suggests a role for vitamin K in preserving BMD. This requires further study.
University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
Badr
B
Aljarallah
Gail
G
Fernandes
Khursheed N
KN
Jeejeebhoy
Leah M
LM
Gramlich
J S
JS
Whittaker
David
D
Armstrong
Don R
DR
Duerksen
Johane P
JP
Allard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage; D002170:Canada; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004164:Diphosphonates / Q000008:administration & dosage; D005260:Female; D006615:Hip; D006801:Humans; D008159:Lumbar Vertebrae / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016562:Parenteral Nutrition, Home Total / Q000379:methods*; D012042:Registries; D014812:Vitamin K / Q000008:administration & dosage*; D055815:Young Adult
D002136:Calcium, Dietary; D004164:Diphosphonates; D014812:Vitamin K