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.