title: Vitamin K deficiency evaluated by serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa with bone loss.
abstract: OBJECTIVE
  Osteoporosis is a chief complication in patients with anorexia nervosa. Serum levels of undercarboxylated osteocalcin reflect serum and bone vitamin K deficiency. We investigated vitamin K status in patients with anorexia nervosa to help establish prevention and treatment recommendations for osteoporosis.
  
  
  METHODS
  Fifty-four female amenorrheic patients with anorexia nervosa (29 restricting-type and 25 binge eating/purging type) (age, 28.0 (26.7-31.1) (mean (95% CI)) years; body mass index, 14.8 (14.1-15.5) kg/m(2), duration of illness; 107.3 (88.5-126.0) months) and 15 age-matched healthy females were included in this study. We measured serum levels of undercarboxylated osteocalcin, biochemical and nutritional markers, and bone metabolic markers. Dietary vitamin K intake was evaluated by a questionnaire.
  
  
  RESULTS
  Lumbar bone mineral density and T-scores in patients with anorexia nervosa were 0.756 (0.721-0.790) g/cm(2) and -2.4 (-2.1 to -2.7), respectively, indicating bone loss. Serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa were significantly higher than those of controls. The 17% of restricting type and 40% of binge eating/purging type anorexia nervosa patients, serum levels of undercarboxylated osteocalcin were higher than 4.5 ng/ml and were diagnosed with vitamin K deficiency. Serum levels of undercarboxylated osteocalcin correlated significantly and negatively with vitamin K intake in patients with anorexia nervosa.
  
  
  CONCLUSIONS
  Patients with anorexia nervosa had vitamin K deficiency. Since a supplement of vitamin K might be effective for maintaining bone quality, we provide recommendations regarding vitamin K intake for prevention and treatment of osteoporosis in patients with AN.
authors.affiliation: Division of Endocrinology and Metabolism, Saitama Sekishinkai Hospital, Saitama, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Urano
authors.affiliation: Health Service Center, National Graduate Institute For Policy Studies, Tokyo, Japan; Institute of Women's Health, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: marihs@grips.ac.jp.
authors.forename: Mari
authors.initials: M
authors.lastname: Hotta
authors.affiliation: Division of Endocrinology and Metabolism, Saitama Sekishinkai Hospital, Saitama, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Ohwada
authors.affiliation: Department of Internal Medicine, Nagai Hitachinomori Hospital, Ibaraki, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Araki
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood* / Q000150:complications; D001842:Bone and Bones / Q000378:metabolism; D052018:Bulimia Nervosa / Q000097:blood / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009752:Nutritional Status; D015675:Osteocalcin / Q000097:blood*; D010024:Osteoporosis / Q000097:blood / Q000209:etiology; D011795:Surveys and Questionnaires; D014812:Vitamin K / Q000097:blood*; D014813:Vitamin K Deficiency / Q000097:blood* / Q000150:complications
chemical_list: D015415:Biomarkers; D015675:Osteocalcin; D014812:Vitamin K
keywords: Anorexia nervosa; Osteoporosis; Undercarboxylated osteocalcin; Vitamin K