OBJECTIVES We aimed to determine serum 25-hydroxyvitamin D (25(OH)D) and undercarboxylated osteocalcin (ucOC) levels in severe motor and intellectual disabilities (SMID) patients and their association with bone turnover biomarkers. METHODS We assessed vitamin D and K levels as indicators of osteoporosis in institutionalized adults with SMID. From December 2019 to February 2020, 93 institutionalized patients (48 men, 45 women; median age, 49 years) underwent annual routine examinations. Serum ucOC, 25(OH)D, bone-specific alkaline phosphatase (BAP), and tartrate-resistant acid phosphatase A 5b (TRACP-5b) levels as bone formation and resorption markers and calcium and phosphorous levels were measured. Vitamin K deficiency was indirectly assessed based on ucOC levels. RESULTS Mean ucOC levels were higher than normal (i.e., vitamin K deficiency). Serum 25(OH)D levels were markedly diminished. Overall, 86% of patients had deficient 25(OH)D levels. These 25(OH)D-deficient patients had higher ucOC levels. Multiple linear regression analysis revealed an inverse correlation between 25(OH)D and ucOC levels. ucOC levels were significantly higher and 25(OH)D levels were significantly lower in tube feeding. TRACP-5b levels were significantly higher in elderly than in young women. BAP and TRACP-5b levels were normal in adults. No relationship existed between vitamin D and antiepileptic drug use. CONCLUSIONS Vitamin K and D co-deficiency was common in SMID patients. Vitamin K and D deficiencies were worse in tube-fed patients than in oral intake patients. SMID patients should undergo regular monitoring of vitamin D and K levels and supplementation of these vitamins.

中文翻译：

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严重运动和智障患者的维生素 K 和 D 缺乏症

目的 我们旨在确定严重运动和智力障碍 (SMID) 患者的血清 25-羟基维生素 D (25(OH)D) 和羧化不足的骨钙素 (ucOC) 水平及其与骨转换生物标志物的关联。方法 我们评估了维生素 D 和 K 水平作为患有 SMID 的机构化成人骨质疏松症的指标。2019 年 12 月至 2020 年 2 月，93 名住院患者（48 名男性，45 名女性；中位年龄 49 岁）接受了年度常规检查。测量血清 ucOC、25(OH)D、骨特异性碱性磷酸酶 (BAP) 和抗酒石酸酸性磷酸酶 A 5b (TRACP-5b) 作为骨形成和吸收标志物的水平以及钙和磷水平。维生素 K 缺乏是根据 ucOC 水平间接评估的。结果 平均 ucOC 水平高于正常水平（即维生素 K 缺乏症）。血清 25(OH)D 水平显着降低。总体而言，86% 的患者缺乏 25(OH)D 水平。这些 25(OH)D 缺乏症患者的 ucOC 水平较高。多元线性回归分析显示 25(OH)D 和 ucOC 水平呈负相关。在管饲中，ucOC 水平显着升高，25(OH)D 水平显着降低。TRACP-5b 水平在老年人中显着高于年轻女性。成人的 BAP 和 TRACP-5b 水平正常。维生素 D 与抗癫痫药物的使用之间不存在任何关系。结论 维生素 K 和 D 共同缺乏在 SMID 患者中很常见。管饲患者维生素 K 和 D 缺乏症比口服患者更严重。SMID 患者应定期监测维生素 D 和 K 水平并补充这些维生素。