vitamin-k-1 and Chronic-Disease

We report the deliberate ingestion of a superwarfarin product, brodifacoum, in a 39-y-old male. He presented with prothrombin and partial thromboplastin times of 150 and 113 sec, respectively. His coagulopathy was corrected by administration of blood products and phytonadione. To maintain normal clotting studies this patient required the highest maintenance dose of phytonadione, 200 mg/d, reported to date. The patient was able to tolerate this dose for 5 mo without adverse effects.

Topics: 4-Hydroxycoumarins; Adult; Blood Coagulation Disorders; Chronic Disease; Humans; Male; Partial Thromboplastin Time; Prothrombin Time; Rodenticides; Suicide, Attempted; Vitamin K 1

Vitamin K has been associated with various health outcomes, including non-fatal cardiovascular diseases (CVD) and cancer. However, little is known about the association between vitamin K intake and all-cause and cause specific mortality. This study aims to investigate the association between vitamin K intake and all-cause and cause-specific mortality.. This prospective cohort study included 33,289 participants from the EPIC-NL cohort, aged 20-70 years at baseline and recruited between 1993 and 1997. Dietary intake was assessed at baseline with a validated food frequency questionnaire and intakes of phylloquinone, and total, short chain and long chain menaquinones were calculated. Information on vital status and causes of death was obtained through linkage to several registries. The association between the different forms of vitamin K intake and mortality was assessed with Cox proportional hazards, adjusted for risk factors for chronic diseases and nutrient intake.. During a mean follow-up of 16.8 years, 2863 deaths occurred, including 625 from CVD (256 from coronary heart disease (CHD)), 1346 from cancer and 892 from other causes. After multivariable adjustment, phylloquinone and menaquinones were not associated with all-cause mortality with hazard ratios for the upper vs. the lowest quartile of intake of 1.04 (0.92;1.17) and 0.94 (0.82;1.07) respectively. Neither phylloquinone intake nor menaquinone intake was associated with risk of CVD mortality. Higher intake of long chain menaquinones was borderline significantly associated (p. Vitamin K intake was not associated with all-cause mortality, cancer mortality and mortality from other causes.

Topics: Adult; Aged; Body Mass Index; Cardiovascular Diseases; Chronic Disease; Fatty Acids; Fatty Acids, Monounsaturated; Fatty Acids, Unsaturated; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Mortality; Neoplasms; Nutrition Assessment; Prevalence; Proportional Hazards Models; Prospective Studies; Risk Factors; Surveys and Questionnaires; Vitamin K; Vitamin K 1; Vitamin K 2; Young Adult

Vitamin K, vitamin K-dependent proteins, and vitamin D may be involved in the regulation of calcification in chronic kidney disease (CKD).. Vitamin K and D status was measured as dietary intake, plasma phylloquinone, serum percent uncarboxylated osteocalcin (%ucOC), proteins induced by vitamin K absence (PIVKA-II), Vitamin K Epoxide Reductase single-nucleotide polymorphism, apolipoprotein E genotype, and plasma 25-hydroxyvitamin D (25(OH)D) in 172 subjects with stage 3 to 5 CKD. Nutritional status was determined by subjective global assessment.. Subclinical vitamin K deficiency criteria was met by 6% (phylloquinone), 60% (%ucOC), and 97% (PIVKA-II) of subjects, whereas 58.3% and 8.6% had 25(OH)D insufficiency and deficiency, respectively. Dietary vitamin K intake was associated with higher phylloquinone and lower PIVKA-II. There were positive correlations between phylloquinone and the presence of stable weight, and the absence of subcutaneous fat loss or muscle wasting. 25(OH)D levels were positively associated with stable weight and albumin (P < 0.001). PIVKA-II levels were associated with apolipoprotein E genotype. Higher %ucOC and lower 25(OH)D were similarly associated with CKD stage, parameters of mineral metabolism, and urine albumin to creatinine ratio.. These data indicate that a suboptimal vitamin K and D status is prevalent in patients with CKD. Sufficiency of both vitamins K and D was similarly predicted by measures of overall improved nutritional status. Proteinuria was associated with both a suboptimal vitamin D status as well as worse peripheral vitamin K status.

Topics: Adult; Aged; Aged, 80 and over; Apolipoproteins E; Biomarkers; Chronic Disease; Cross-Sectional Studies; Diet; Female; Genetic Markers; Genotype; Humans; Kidney Diseases; Linear Models; Male; Middle Aged; Mixed Function Oxygenases; Nutritional Status; Osteocalcin; Polymorphism, Single Nucleotide; Protein Precursors; Proteinuria; Prothrombin; Vitamin D; Vitamin D Deficiency; Vitamin K; Vitamin K 1; Vitamin K Deficiency; Vitamin K Epoxide Reductases; Young Adult

To measure directly plasma vitamin K1 in patients with primary biliary cirrhosis (PBC) and to examine the relationship between vitamin K1 level, prothrombin time, other fat-soluble vitamin levels, and severity of cholestasis.. We directly measured levels of vitamin K1 (phylloquinone) in the plasma of 77 patients with PBC using reverse-phase high-performance liquid chromatography, along with serum levels of vitamins A, E, and 25-OH vitamin D.. Median plasma vitamin K1 level was significantly lower in PBC patients compared with 255 normal subjects (0.65 nmol/L; range, 0.05-4.13, vs 0.95 nmol/L; range, 0.2-4.92; p < 0.0001). Of 77 PBC patients, 18 (23%) patients had levels below the normal range for plasma vitamin K1 (<0.3 nmol/L). Only 1 of the 18 patients with decreased vitamin K1 had a prolonged prothrombin time. There was no correlation between vitamin K1 level and prothrombin time in the PBC patients (p = 0.75); there was also no difference in prothrombin time between PBC patients with low vitamin K1 level and PBC patients with normal vitamin K1 level (10.3 vs 10.0 seconds; p = 0.28). PBC patients with decreased vitamin K1 levels had significantly lower vitamin A and vitamin E levels, and significantly higher serum bilirubin levels than those with normal vitamin K1 levels.. Decreased plasma vitamin K1 level is common in PBC, and is associated with decreased serum levels of vitamins A and E. However, the majority of PBC patients with decreased plasma vitamin K1 levels have normal prothrombin times. Although the prothrombin time is an insensitive marker of vitamin K1 status in PBC patients, clinically important vitamin K deficiency seems uncommon.

Topics: Chi-Square Distribution; Chromatography, High Pressure Liquid; Chronic Disease; Female; Humans; Liver Cirrhosis, Biliary; Male; Middle Aged; Prothrombin Time; Statistics, Nonparametric; Vitamin K 1

Factor VII levels have been measured in 100 patients with liver disease following parenteral vitamin K1 therapy. There was good agreement between specific factor VII measurements and the one-stage prothrombin time apart from six patients with compensated cirrhosis in whom the prothrombin time was prolonged despite the presence of normal factor VII levels. A mean activity of 58% was found in patients with cirrhosis. Cirrhotic patients with features of hepatic decompensation had a significantly lower mean level of activity (40%) than the "contrast" patients with surgical obstruction of the major bile ducts (93%). Patients with chronic active liver disease had moderate depression of factor VII levels and those with non-cirrhotic liver damage had mean activities similar to the contrast group. Factor VII levels could not be correlated with BSP retention but there was a correlation with serum albumin concentration. It is concluded that the prothrombin time using Quick test with a standardized thromboplastin showing good sensitivity to factor VII, eg, the Manchester reagent (BCT), provides a reliable index of coagulability in chronic liver disease, and specific factor VII assays are not indicated.

Topics: Cholestasis; Chronic Disease; Factor VII; Humans; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Prothrombin Time; Vitamin K 1

Topics: Aged; Chronic Disease; Cystitis; Cystoscopy; Estrogens, Conjugated (USP); Female; Hematuria; Hemorrhage; Humans; Lymphoma, Non-Hodgkin; Urinary Bladder Neoplasms; Vitamin K 1

Topics: Acute Disease; Adolescent; Adult; Aged; Biotransformation; Chronic Disease; Ethers; Fructose; Half-Life; Hepatitis A; Humans; Hypoglycemic Agents; Liver Diseases; Middle Aged; Pyrimidines; Renal Dialysis; Spectrophotometry; Sulfonamides; Tolbutamide; Transaminases; Vitamin K 1; Vitamins