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 (vitK(1)), 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, vitK(1), and calcium intake; serum 25 (OH) D, 1,25(OH)(2)D; 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, vitK(1), 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). VitK(1) intake (>= 200 mu g/day) was associated with higher whole-body and femoralneck BMDs (absoluteand T-scores; P <= 0.05).
Conclusion: VitD status and BMD in adults with DM and CKD was influenced by vitD supplementation and vitK(1) intake.