Vitamin D Status and Bone Mineral Density is Influenced by Vitamin D Supplementation and Vitamin K1 Intake in Adults with Diabetes and Chronic Kidney Disease
Publication: Canadian Journal of Dietetic Practice and Research
25 October 2016
Abstract
Purpose: Patients with diabetes (DM) and chronic kidney disease (CKD) are at increased risk for suboptimal bone health. The study objective was to investigate the relationships between vitamin D (vitD), vitamin K1 (vitK1), and calcium intake with bone mineral density (BMD) and vitamin D status in an ambulatory population with DM and CKD.
Methods: Adults (age 18–80 years; n = 62) with DM and CKD (stages 1–4) were recruited from the Northern Alberta Renal Program. Primary outcome variables included vitD, vitK1, and calcium intake; serum 25(OH)D, 1,25(OH)2D; and BMD as measured by dual X-ray absorptiometry. Statistical significance was determined at P < 0.05.
Results: Participants met the estimated average requirement or adequate intake for vitD, vitK1, and calcium intake in 73% (n = 45), 66% (n = 39), and 52% (n = 31), respectively, with a combined intake of micronutrient supplementation and diet. Participants had serum 25(OH)D concentrations ≥75 nmol/L (n = 41), normal BMDs (n = 48), and 66% (n = 41/62) were taking vitD supplements (>1000 IU/D). BMD was positively influenced by serum 25(OH)D. However, serum 25(OH) ≥100 nmol/L was associated with lower BMD (absolute and T-scores) for whole-body and spine (P ≤ 0.05). VitK1 intake (≥200 μg/day) was associated with higher whole-body and femoral–neck BMDs (absoluteand T-scores; P ≤ 0.05).
Conclusion: VitD status and BMD in adults with DM and CKD was influenced by vitD supplementation and vitK1 intake.
Résumé
Objectif : Les patients atteints de diabète et de maladie du rein chronique (MRC) présentent un risque accru d’avoir une santé osseuse sous-optimale. L’étude visait à étudier la relation entre l’apport en vitamine D, en vitamine K1 et en calcium et la densité minérale osseuse (DMO) et le statut en vitamine D chez une population ambulatoire atteinte de diabète et de MRC.
Méthodes : Des adultes (âgés de 18 à 80 ans; n = 62) atteints de diabète et de MRC (stades 1 à 4) ont été recrutés du Northern Alberta Renal Program. Les variables dépendantes principales incluaient l’apport en vitamine D, en vitamine K1 et en calcium; les taux sériques de 25(OH)D et de 1,25(OH)2D; et la DMO mesurée à l’aide de l’absorptiométrie à rayon X en double énergie. La signification statistique a été déterminée à P < 0,05.
Résultats : Les participants ont atteint le besoin moyen estimatif ou l’apport suffisant en vitamine D, en vitamine K1 et en calcium à raison de 73 % (n = 45), de 66 % (n = 39) et de 52 % (n = 31), respectivement, avec un apport combiné comprenant la supplémentation en oligo-éléments et l’alimentation. Les participants ont obtenu des taux sériques de 25(OH)D de ≥ 75 nmol/l (n = 41), des DMO normales (n = 48), et 66 % des participants (n = 41/62) prenaient des suppléments de vitamine D (> 1000 IU/jour). La DMO a été influencée de manière positive par le taux sérique de 25(OH)D. Cependant, les taux sériques de 25(OH) ≥ 100 nmol/l étaient associés à une DMO plus faible (absolue et scores T) pour le corps entier et la colonne vertébrale (P ≤ 0,05). L'apport en vitamine K1 (≥ 200 μg/jour) a été associé à des DMO plus élevées pour le corps entier et pour le col fémoral (absolue et scores T; P ≤ 0,05).
Conclusion : Le statut en vitamine D et la DMO chez les adultes atteints de diabète et de MRC étaient influencés par la supplémentation en vitamine D et l’apport en vitamine K1.
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Funding: Funding for this project was provided by the Canadian Foundation for Dietetic Practice and Research. Personal funding provided by the G. Woodrow Wirtanen Studentships (MRH, STJ, PL, Alberta Diabetes Institutes, University of Alberta). Doctoral recruitment scholarship (MRH), CIHR MSc Scholarship (STJ), Dietitians of Canada Graduate Award (STJ), Anthony Clinical Nutrition Fellowship (STJ), and Saudi Cultural Bureau (AA) is gratefully acknowledged.
Conflict of interest: None to report.
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Canadian Journal of Dietetic Practice and Research
Volume 78 • Number 1 • March 2017
Pages: 11 - 19
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Version of record online: 25 October 2016
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© 2017.
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Michelle R.Hoffmann, Peter A.Senior, Stephanie T.Jackson, GuylaineFerland, NancyPresse, KailashJindal, PingLi, Abeer S.Alzaben, and Diana R.Mager. 2017. Vitamin D Status and Bone Mineral Density is Influenced by Vitamin D Supplementation and Vitamin K1 Intake in Adults with Diabetes and Chronic Kidney Disease. Canadian Journal of Dietetic Practice and Research.
78(1): 11-19. https://doi.org/10.3148/cjdpr-2016-023
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