Vitamin K and Bone in Children with Cerebral Palsy

脑瘫儿童的维生素 K 和骨骼

• 批准号: 7143764
• 负责人: CHRISTOPHER M MODLESKY
• 金额: $ 7.55万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-15 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7143764
• 关键词: blood chemistry; body physical activity; bone development disorder; bone fracture; carboxylation; cerebral palsy; clinical research; diet; disease /disorder proneness /risk; femur; growth /development; human subject; magnetic resonance imaging; middle childhood (6-11); molecular dynamics; musculoskeletal disorder diagnosis; musculoskeletal imaging /visualization /scanning; osteocalcin; personal log /diary; photon absorptiometry; trabecular meshwork; urinalysis; vitamin K; vitamin K deficiency

DESCRIPTION (provided by applicant): Cerebral palsy (CP) is a brain disorder that can seriously impair movement and posture. A major secondary complication of moderate to severe CP is a substantial compromise of bone development and a high incidence of fracture in the femur. One factor that is closely tied to fracture but has not been evaluated in children with CP is vitamin K status. Vitamin K is necessary for the carboxylation of osteocalcin. Undercarboxylation of osteocalcin is associated with poor mineralization of the skeleton. Interestingly, vitamin K intake is not consistently associated with areal bone mineral density (aBMD), the primary marker of skeletal fragility, but it is associated with fracture. This discordance suggests vitamin K is more closely tied to features of the skeleton not captured by aBMD. It has been inferred that the level of carboxylated osteocalcin is associated with the trabecular microarchitecture and geometric structure of bone. Our long- term goal is to develop strategies that maximize growth and development of bone and reduce the incidence of fracture in children with CP. The specific aims of this study are: 1) to determine if children with moderate to severe CP have a higher level of undercarboxylated osteocalcin in the serum than children without CP;2) to determine if undercarboxylated osteocalcin is inversely related to the status of trabecular microarchitecture, geometric structure and strength of the femur in children with and without CP; and 3) to determine if undercarboxylated osteocalcin is inversely related to aBMD and bone mineral content in the femur in children with and without CP. To address our aims, 7 to 11 year-old prepubertal children with moderate to severe CP and children without CP will be studied. If the level of undercarboxylated osteocalcin is elevated in children with CP and if it is inversely related to trabecular microarchitecture, geometric structure and strength of bone, it would suggest that vitamin K may play an important role in fracture prevention in children with CP or other physical disabilities.

描述（由申请人提供）：脑瘫（CP）是一种大脑疾病，可以严重损害运动和姿势。中度至重度CP的主要次要并发症是骨骼发育的实质性折衷和股骨骨折的高发生率。与骨折紧密相关但尚未在CP儿童中评估的因素是维生素K状态。维生素K是骨钙素的羧化所必需的。骨钙素的羧化羧化与骨骼的矿化差有关。有趣的是，维生素K摄入量与骨骼脆弱性的主要标志物（ABMD）并不始终如一，但与骨折有关。这种不和谐表明，维生素K与ABMD未捕获的骨架的特征更加紧密相关。已经推断出羧化骨钙素的水平与骨的小梁微体系结构和几何结构有关。我们的长期目标是制定最大化骨骼生长和发展的策略，并减少CP儿童骨折的发生率。这项研究的具体目的是：1）确定患有中度至重度CP的儿童是否在血清中比没有CP的儿童具有更高水平的羧化骨钙素水平； 3）要确定羧化骨钙素是否与患有和没有CP的儿童的股骨中的ABMD和骨矿物质含量成反比。为了解决我们的目标，将研究7至11岁的患有中度至重度CP的青春期前儿童，而没有CP的儿童将被研究。如果CP儿童的羧化骨钙化蛋白的水平升高，并且与小梁微体系结构，几何结构和骨骼的强度成熟相关，则表明维生素K可能在CP儿童的骨折预防中起重要作用。