Detection And Clinical Significance Of Vitamin K In Children With Vitamin D Deficiency Rickets

Objective:To explore the correlation between serum vitamin K level and vitamin D deficiency rickets in children,clarify the clinical diagnostic value of vitamin K in the diagnosis of vitamin D deficiency rickets,and provide evidence-based and data support for the prevention,diagnosis and prognosis of bone metabolic diseases in children.Methods:44 children with vitamin D deficiency rickets diagnosed from 3 months to 2 years old in pediatrics of our hospital from January 2019 to January 2021 were selected as the case group,and 44 normal physical examination children from 3 months to 2years old in the same period were selected as the control group.Collect two groups of basic information(such as age,height,weight,etc.),bone mineral density(BMD),bone alkaline phosphatase(BALP)and other indicators,collect elbow vein blood samples,and detect the levels of vitamin D and vitamin K by high performance liquid chromatography tandem mass spectrometry(HPLC-MS / MS),Logistic linear regression analysis model was used to analyze the independent risk factors of bone metabolism,and to explore the correlation between vitamin K deficiency and abnormal bone metabolism.Result:1.there was no significant difference between the two groups in age,sex,height,weight,CA,P,BALP and other conventional indicators(P > 0.05).2.there was no significant difference in height,weight,vitamin D3 level,CA,P and BALP levels between the vitamin K1 level(< 0.1ng/ml)group and the vitamin K1 level(≥ 0.1ng/ml)group(P > 0.05),while the weight,height,vitamin D3,CA,P and BALP levels of children in the vitamin K2(< 0.1ng/ml)group were lower than those in the vitamin K2(≥ 0.1ng/ml)group(P < 0.05).3.the ratio of vitamin K1 and K2 deficiency in the case group was 27.27% and86.36% respectively,higher than that in the control group(x2=8.494,52.654,P <0.05),suggesting that vitamin K1 and K2 deficiency may increase the risk of vitamin D-deficient rickets.4.Pearson correlation analysis showed that vitamin K1 was positively correlated with 25-(OH)D3,Ca and P(r=0.365,0.308,0.325,P <0.05);There was a positive correlation between vitamin K2 and 25-(OH)D3,CA,P(r=0.476,0.460,0.377,P<0.05).5.logistic regression analysis showed that vitamin K1 and K2 were the single factors affecting vitamin D deficiency rickets(P < 0.05).6.vitamin D deficiency rickets is closely related to vitamin K1 deficiency(<0.216ng/ml)and K2 deficiency(< 0.184ng/ml),and is an independent risk factor for the disease.7.two ROC curves were drawn based on the expression of vitamin K in the control group and the case group.The cut-off values for the prediction and diagnosis of vitamin K1 and K2 were k1=0.216ng/ml and k2=0.184ng/ml.Conclusion:1.children with vitamin D deficiency rickets have significant vitamin K deficiency,especially vitamin K2 deficiency.2.vitamin K1 and K2 affect bone metabolism in children with vitamin D deficiency rickets,and they are positively correlated with vitamin D deficiency rickets.3.vitamin K1 and K2 are one of the independent risk factors of bone metabolism in children with vitamin D deficiency rickets.4.vitamin K1 and K2 can be used as the diagnosis and treatment of vitamin D deficiency rickets.