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Vitamin K deficiency in cystic fibrosis

IHN logo TORONTO, CANADA. Cystic fibrosis (CF) is often accompanied by pancreatic insufficiency (inability to absorb fat and fat-soluble vitamins through the intestines). CF patients routinely receive supplements of vitamin A, vitamin D and vitamin E, but it is still controversial whether vitamin K, another fat-soluble vitamin, should also be supplemented. Now researchers at Toronto's Hospital for Sick Children provide convincing proof that most CF patients with pancreatic insufficiency do indeed suffer from a vitamin K deficiency and that supplementation may be beneficial.

The study involved 83 CF patients with pancreatic insufficiency (average age of 15.2 years), 15 patients who were pancreatic sufficient (average age of 26.2 years), and 62 healthy controls (average age of 16.2 years). The researchers measured vitamin K status in all participants by determining the amount of incompletely carboxylated proteins (proteins induced by a vitamin K deficiency) in blood plasma. All control subjects had a concentration below three micrograms/liter. CF patients with pancreatic insufficiency had a considerably higher average level of these so-called PIVKA-II proteins varying from 46.6 micrograms/liter for patients with liver disease to 15.3 micrograms/liter for those without liver disease. The average PIVKA-II level for CF patients without pancreatic insufficiency was moderately elevated at 3.4 micrograms/liter. All told, 78 per cent of pancreatic insufficient CF patients had elevated PIVKA-II levels indicating a significant vitamin K deficiency. The researchers recommend that routine vitamin K supplementation be considered in all cystic fibrosis patients with pancreatic insufficiency. NOTE: This study was supported in part by Scandipharm Inc. and Janssen Pharmaceutica.
Rashid, Mohsin, et al. Prevalence of vitamin K deficiency in cystic fibrosis. American Journal of Clinical Nutrition, Vol. 70, September 1999, pp. 378-82

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