Effect of vitamin K1 supplementation on vitamin K status in cystic fibrosis patients

Leila T. Beker, Richard A. Ahrens, Robert J. Fink, Maureen E. O'Brien, Kenneth W. Davidson, Lori J Sokoll, James A. Sadowski

Research output: Contribution to journalArticle

Abstract

Background: Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1 supplementation in cystic fibrosis patients. Methods: Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1 (phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4-week study treatment of 5 mg oral vitamin K1 supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre-study and at the end of each study period. Results: The mean concentration of plasma vitamin K1 for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p <0,05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17% to 31%, (p <0.005). Prothrombin induced in vitamin K absence (PIVKA-II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p <0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods. Conclusions: In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1 supplementation. The carboxylation state of osteocalcin and PIVKA-II were the most sensitive indices of changes in vitamin K1 status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.

Original languageEnglish (US)
Pages (from-to)512-517
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume24
Issue number5
DOIs
StatePublished - May 1997
Externally publishedYes

Fingerprint

Vitamin K 1
phylloquinone
vitamin K
Vitamin K
cystic fibrosis
Cystic Fibrosis
osteocalcin
Osteocalcin
Exocrine Pancreatic Insufficiency
prothrombin
malabsorption
carboxylation
Prothrombin
blood serum
Cross-Over Studies
creatinine
mouth
Creatinine
Outpatients
urine

Keywords

  • Cystic fibrosis
  • Osteocalcin
  • PIVKA-II
  • Vitamin K

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)
  • Gastroenterology
  • Histology
  • Pediatrics, Perinatology, and Child Health

Cite this

Effect of vitamin K1 supplementation on vitamin K status in cystic fibrosis patients. / Beker, Leila T.; Ahrens, Richard A.; Fink, Robert J.; O'Brien, Maureen E.; Davidson, Kenneth W.; Sokoll, Lori J; Sadowski, James A.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 24, No. 5, 05.1997, p. 512-517.

Research output: Contribution to journalArticle

Beker, Leila T. ; Ahrens, Richard A. ; Fink, Robert J. ; O'Brien, Maureen E. ; Davidson, Kenneth W. ; Sokoll, Lori J ; Sadowski, James A. / Effect of vitamin K1 supplementation on vitamin K status in cystic fibrosis patients. In: Journal of Pediatric Gastroenterology and Nutrition. 1997 ; Vol. 24, No. 5. pp. 512-517.
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abstract = "Background: Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1 supplementation in cystic fibrosis patients. Methods: Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1 (phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4-week study treatment of 5 mg oral vitamin K1 supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre-study and at the end of each study period. Results: The mean concentration of plasma vitamin K1 for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p <0,05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17{\%} to 31{\%}, (p <0.005). Prothrombin induced in vitamin K absence (PIVKA-II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p <0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods. Conclusions: In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1 supplementation. The carboxylation state of osteocalcin and PIVKA-II were the most sensitive indices of changes in vitamin K1 status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.",
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AU - Beker, Leila T.

AU - Ahrens, Richard A.

AU - Fink, Robert J.

AU - O'Brien, Maureen E.

AU - Davidson, Kenneth W.

AU - Sokoll, Lori J

AU - Sadowski, James A.

PY - 1997/5

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N2 - Background: Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1 supplementation in cystic fibrosis patients. Methods: Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1 (phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4-week study treatment of 5 mg oral vitamin K1 supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre-study and at the end of each study period. Results: The mean concentration of plasma vitamin K1 for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p <0,05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17% to 31%, (p <0.005). Prothrombin induced in vitamin K absence (PIVKA-II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p <0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods. Conclusions: In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1 supplementation. The carboxylation state of osteocalcin and PIVKA-II were the most sensitive indices of changes in vitamin K1 status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.

AB - Background: Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1 supplementation in cystic fibrosis patients. Methods: Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1 (phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4-week study treatment of 5 mg oral vitamin K1 supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre-study and at the end of each study period. Results: The mean concentration of plasma vitamin K1 for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p <0,05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17% to 31%, (p <0.005). Prothrombin induced in vitamin K absence (PIVKA-II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p <0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods. Conclusions: In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1 supplementation. The carboxylation state of osteocalcin and PIVKA-II were the most sensitive indices of changes in vitamin K1 status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.

KW - Cystic fibrosis

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