回复8楼 fengsh
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VitK2治疗帕金森症在剂量和疗效上没有一个共识，我仅探讨一个安全剂量和用于中老年帕症特别是女性病人的骨质疏松症（OP)的治疗。OP是老年女性帕症的常见病，会导致骨折，比如髋部（粗隆间或股骨颈骨折），Colles骨折（腕部）和脊柱压缩性骨折。
日本是批准VitK2治疗骨质疏松症的，还有韩国和泰国，用的剂量是每天45mg,一般是分三次服用，安全程度和疗效比福善美等阿仑膦酸钠类药物更好，特别是脊椎部位骨密度的改善，当然还包括髋骨和手掌骨，以下是一个12个月的临床，还有36个月的。
即使是每天45mg的VitK2也是安全的，所以我一般推荐每天3次，每次5mg.如果是检查出有严重骨质疏松的病人，就可以达到每天45mg.
Menatetrenone即我们讲的VitK2.除了VitK2,也建议病友多晒太阳。
Amelioration of osteoporosis by menatetrenone in elderly female Parkinson’s disease patients with vitamin D deficiency
Y Sato1, Y Honda2, M Kaji3, T Asoh4, K Hosokawa1, I Kondo1, K Satoh5
1 Department of Rehabilitation Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
5 Department of Vascular Biology, Hirosaki University School of Medicine, Hirosaki, Japan
2 Department of Neurology, Ohshima Hospital, Kita-Shigeyasu, Japan
3 Department of Neurology, Kurume University Medical Center, Kurume, Japan
4 Department of Internal Medicine, Futase Social Insurance Hospital, Iizuka, Japan
Referred to byY. Sato, Y. Honda, M. Kaji, T. Asoh, K. Hosokawa, I. Kondo, K. Satoh
Corrigendum to “Amelioration of osteoporosis by menatetrenone in elderly female Parkinson’s disease patients with vitamin D deficiency” [Bone 31 (2002) 114–118]
Abstract
Significant reduction in bone mineral density (BMD) occurs in patients with Parkinson’s disease (PD), correlating with immobilization and with vitamin D deficiency, and increasing the risk of hip fracture, especially in elderly women. As a biological indicator of compromised vitamin K status, an increased serum concentration of undercarboxylated osteocalcin (Oc) has been associated with reduced BMD in the hip and an increased risk of fracture in otherwise healthy elderly women. We evaluated treatment with vitamin K2 (menatetrenone; MK-4) in maintaining BMD and reducing the incidence of nonvertebral fractures in elderly female patients with PD. In a random and prospective study of PD patients, 60 received 45 mg of MK-4 daily for 12 months, and the remaining 60 (untreated group) did not. At baseline, patients of both groups showed vitamin D and K1 deficiencies, high serum levels of ionized calcium, and glutaminic residue (Glu) Oc, and low levels of parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D [1,25-(OH)2D], indicating that immobilization-induced hypercalcemia inhibits renal synthesis of 1,25-(OH)2D and compensatory PTH secretion. BMD in the second metacarpals increased by 0.9% in the treated group and decreased by 4.3% in the untreated group (p < 0.0001). Vitamin K2 level increased by 259.8% in the treated group. Correspondingly, significant decreases in Glu Oc and calcium were observed in the treated group, in association with an increase in both PTH and 1,25-(OH)2D. Ten patients sustained fractures (eight at the hip and two at other sites) in the untreated group, and one hip fracture occurred among treated patients (p = 0.0082; odds ratio = 11.5). The treatment with MK-4 can increase the BMD of vitamin D- and K-deficient bone by increasing vitamin K concentration, and it can also decrease calcium levels through inhibition of bone resorption, resulting in an increase in 1,25-(OH)2D concentration.
Keywords
Fracture; Immobilization; Menatetrenone (MK-4); Osteoporosis; Parkinson’s disease (PD)
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