vitamin-k-semiquinone-radical and Celiac-Disease

Bone health, characterized by its mass, density, and micro-architectural qualities, is maintained by a balanced system of remodeling. The lack of these qualities, caused by an uncoupling of the remodeling process, leads to bone fragility and an increased risk for fracture. The prime regulator of bone remodeling is the RANK/RANKL/OPG system. The common origin of both bone and immune stem cells is the key to understanding this system and its relationship to the transcription factor nuclear factor kappaB in bone loss and inflammation. Via this coupled osteo-immune relationship, a catabolic environment from heightened proinflammatory cytokine expression and/or a chronic antigen-induced activation of the immune system can initiate a switch-like diversion of osteoprogenitor-cell differentiation away from monocyte-macrophage and osteoblast cell formation and toward osteoclast and adipocyte formation. This disruption in bone homeostasis leads to increased fragility. Dietary and specific nutrient interventions can reduce inflammation and limit this diversion. Common laboratory biomarkers can be used to assess changes in body metabolism that affect bone health. This literature review offers practical information for applying effective strategic nutrition to fracture-risk individuals while monitoring metabolic change through serial testing of biomarkers. As examples, the clinician may recommend vitamin K and potassium to reduce hypercalciuria, _-lipoic acid and N-acetylcysteine to reduce the bone resorption marker N-telopeptide (N-Tx), and dehydroepiandrosterone (DHEA), whey, and milk basic protein (the basic protein fraction of whey) to increase insulin-like growth factor-1 (IGF-1) and create a more anabolic profile.

Topics: Absorptiometry, Photon; Acidosis; Biomarkers; Bone Density; Bone Remodeling; C-Reactive Protein; Calcium; Celiac Disease; Dehydroepiandrosterone; Female; Gonadal Steroid Hormones; Humans; Hydrocortisone; Hyperhomocysteinemia; Male; Osteoporosis; Osteoprotegerin; RANK Ligand; Receptor Activator of Nuclear Factor-kappa B; Thyroid Diseases; Vitamin D; Vitamin K

Topics: Adult; Alkylation; Biological Transport; Celiac Disease; Cholestasis; Dietary Fats; Feces; Humans; Infant; Intestinal Absorption; Intestines; Lipid Metabolism; Malabsorption Syndromes; Oxides; Pancreatitis; Tritium; Vitamin K; Vitamin K 1; Warfarin

Pathologies associated with gluten intake are increasingly prevalent. Diagnosis of celiac disease (CD) or non-celiac gluten sensitivity (NCGS) is based on compatible clinical alterations and in case of CD on compatible serology or intestinal biopsy. The aim was to determine the values of iron, vitamins and minerals. Calcium levels in celiac patients follow a positive trend after 3 months of gluten-free diet. Ferritin levels in patients with NCGS increased in a statistically significant way (p < 0.017).. Calcium in the CD group increases its values after the establishment of a gluten-free diet as treatment, as well as ferritin in patients with NCGS. No significant changes were found in the rest of the analyzed parameters. This could be

Topics: Adolescent; Calcium; Celiac Disease; Child; Ferritins; Food Hypersensitivity; Glutens; Humans; Iron; Minerals; Retrospective Studies; Vitamin A; Vitamin K; Vitamins

Children with celiac disease (CD) are at risk for decreased bone mineral density (BMD) because of fat-soluble vitamin malabsorption, inflammation and/or under-nutrition. The study objective was to determine the interrelationships between vitamin K/D status and lifestyle variables on BMD in children and adolescents with CD at diagnosis and after 1 year on the gluten-free diet (GFD).. Children and adolescents aged 3-17 years with biopsy proven CD at diagnosis and after 1 year on the GFD were studied. BMD was measured using dual-energy X-ray absorptiometry. Relevant variables included: anthropometrics, vitamin D/K status, diet, physical activity and sunlight exposure.. Whole-body and lumbar-spine BMD-z scores were low (< or = -1) at diagnosis (10-20%) and after 1 year (30-32%) in the children, independent of symptoms. Whole-body BMD-z scores (-0.55±0.7 versus 0.72±1.5) and serum levels of 25(OH) vitamin D (90.3±24.8 versus 70.5±19.8 nmol/l) were significantly lower in older children (>10 years) when compared with younger children (< or =10 years) (P<0.001). Forty-three percent had suboptimal vitamin D status (25(OH)-vitamin D <75 nmol/l) at diagnosis; resolving in nearly half after 1 year on the GFD. Twenty-five percent had suboptimal vitamin K status at diagnosis; all resolved after 1 year.. Children and adolescents with CD are at risk for suboptimal bone health at time of diagnosis and after 1 year on GFD; likely due in part to suboptimal vitamin D/K status. Therapeutic strategies aimed at optimizing vitamin K/D intake may contribute to improved BMD in children with CD.

Topics: Absorptiometry, Photon; Adolescent; Anthropometry; Biomarkers; Bone and Bones; Bone Density; Celiac Disease; Child; Child, Preschool; Diet, Gluten-Free; Female; Follow-Up Studies; Humans; Life Style; Logistic Models; Lumbar Vertebrae; Male; Motor Activity; Multivariate Analysis; Surveys and Questionnaires; Vitamin D; Vitamin K; Vitamins

A 53 year old female who was maintained on long-term warfarin therapy due to history of pulmonary embolism, repeatedly presents with an abnormally prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT). After many asymptomatic episodes were corrected with Vitamin K therapy to temporarily reverse the effects of the warfarin, the cause of the apparent coagulopathy was further investigated. Factor Activity Assays of the common pathway factors II, IX, and X all revealed critically low values; below the threshold even a loading dose of warfarin is typically capable of eliciting. The patient tested strongly positive for Tissue Transglutaminase IgA, which is highly suggestive of a gluten-sensitive enteropathy. One effect of this condition is malabsorption due to flattened intestinal villi. The patient was determined to have an acquired vitamin K deficiency secondary to gluten-sensitive enteropathy. Her condition was exacerbated by the long-term warfarin therapy, resulting in the prolonged PT and PTT. The patient was treated with vitamin K therapy, which reversed the deficiency and corrected her abnormal coagulation results.

Topics: Anticoagulants; Blood Coagulation; Blood Coagulation Disorders; Celiac Disease; Drug Hypersensitivity; Female; Humans; International Normalized Ratio; Middle Aged; Partial Thromboplastin Time; Prothrombin Time; Treatment Outcome; Vitamin K; Vitamin K Deficiency; Warfarin

Individuals with celiac disease (CD) are predisposed to a number of haematological abnormalities including anaemia secondary to malabsorption of iron, vitamin B12 or folate; anaemia of chronic disease and coagulopathy secondary to vitamin K deficiency. Correction of coagulopathy with vitamin K is necessary before endoscopic biopsy in patients with suspected CD. However, vitamin K causes haemolysis in glucose-6 phosphate-dehydrogenase deficiency.. When vitamin K administration becomes necessary for correction of coagulopathy in patients with CD; glucose-6 phosphate-dehydrogenase deficiency should be considered.

Topics: Celiac Disease; Contraindications; Diet, Gluten-Free; Endoscopy, Gastrointestinal; Glucosephosphate Dehydrogenase; Glucosephosphate Dehydrogenase Deficiency; Hemolysis; Humans; Infant; Intestinal Mucosa; Male; Vitamin K; Vitamin K Deficiency

A 25-year-old man presented with macroscopic haematuria associated with a body mass index of 20 kg/m and a severe coagulopathy consistent with vitamin K deficiency. The diagnosis of a profound malabsorption syndrome secondary to coeliac disease was confirmed by small bowel histology and positive coeliac serology.

Topics: Abdominal Pain; Adult; Celiac Disease; Cheilitis; Diagnosis, Differential; Duodenum; Hematuria; Humans; Irritable Bowel Syndrome; Male; Treatment Outcome; Vitamin K; Vitamin K Deficiency; Vomiting

Untreated coeliac disease may induce malabsorption of many nutrients. It may also induce vitamin K deficiency, which causes prolongation of the prothrombin time. The aim of the present study was to evaluate the prevalence and associations of prolonged prothrombin time in a series of coeliac adults.. We carried out a cross-sectional analysis of data collected on 390 adults with untreated coeliac disease diagnosed from January 1997 to December 2000. Prolonged prothrombin time was defined as INR > or = 1.4.. A prolonged prothrombin time was found in 72 coeliac patients (18.5%). Parenteral vitamin K therapy was required in 5.6% of patients. Patients with prolonged prothrombin time had significant lower values of haemoglobin, iron, proteins, cholesterol and serum aspartate transaminase, and significantly higher prevalence of diarrhoea, weight loss, abdominal pain and low bone mineral density in comparison with patients with normal prothrombin time. However, low bone density was present in 11.6% of patients with normal INR. A prolonged prothrombin time was only found in a few patients with subclinical coeliac disease (0.9%).. Data indicate that the prevalence of prolonged prothrombin time is about 20% in a large series of adult untreated coeliac patients. A prolonged prothrombin time was significantly related to all the markers of severe malabsorption, including low mineral density. Our suggestion is that vitamin K related proteins may also play a role in determining or worsening calcium homeostasis disorders in coeliac disease. The very low prevalence of coagulation disorders in subclinical coeliac disease indicates that there is no need to screen for coeliac disease in patients with isolated coagulation disorders.

Topics: Adult; Aspartate Aminotransferases; Blood Proteins; Bone Density; Celiac Disease; Cholesterol; Cross-Sectional Studies; Diarrhea; Female; Hemoglobins; Humans; Infusions, Parenteral; Iron; Male; Pain; Prothrombin; Prothrombin Time; Retrospective Studies; Vitamin K; Weight Loss

Topics: Adult; Blood Coagulation Tests; Celiac Disease; Duodenum; Hemorrhagic Disorders; Humans; Male; Treatment Outcome; Vitamin K; Vitamin K Deficiency

Topics: Anticoagulants; Celiac Disease; Diagnosis, Differential; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Mesenteric Vascular Occlusion; Mesenteric Veins; Middle Aged; Thromboplastin; Thrombosis; Vitamin K

Topics: Adult; Age Factors; Blood Coagulation Factors; Celiac Disease; Humans; Male; Prothrombin; Tomography, X-Ray Computed; Vitamin K; Vitamin K Deficiency

Topics: Adult; Blood Coagulation Disorders; Celiac Disease; Female; Humans; Vitamin K

Topics: Celiac Disease; Female; Humans; Intracranial Embolism and Thrombosis; Male; Middle Aged; Vitamin K

Haemorrhagic diathesis was a leading symptom in diagnosing celiac disease in 4 patients. In all 4 patients, a duodenal biopsy showed total villous atrophy. Although 3 of the children were typically dystrophic, the weight of the 4th child, an 8 month old boy, was within the normal range. In this patient, who suffered from neither diarrhea nor vomiting, heavy cutaneous and mucous membrane bleeding were the only symptoms of the disease. In all 4 cases the haemorrhagic diathesis could be explained by a low prothrombin complex, whereas the rest of the coagulation tests were normal. After the administration of Vitamin K1 there was an immediate rise in the prothrombin complex and bleeding was quickly stopped. Noteworthy is that due to infections, 3 of the 4 patients, received antibiotics just before the onset of the bleeding. In celiac disease, the conversion from a K-hypovitaminosis into a K-avitaminosis by the administration of antibiotics is discussed.

Topics: Anti-Bacterial Agents; Celiac Disease; Female; Hemorrhagic Disorders; Humans; Infant; Male; Vitamin K; Vitamin K Deficiency

Topics: Celiac Disease; Female; Gastrointestinal Hemorrhage; Humans; Intestine, Small; Malabsorption Syndromes; Middle Aged; Vitamin K

Topics: Adolescent; Adult; Aged; Celiac Disease; Feces; Female; Humans; Intestinal Absorption; Lipid Metabolism; Liver Cirrhosis; Male; Middle Aged; Vitamin K

Topics: Celiac Disease; Cholestasis; Humans; Intestinal Absorption; Intestine, Small; Pancreatitis; Tritium; Vitamin K

Topics: Adolescent; Adult; Body Height; Body Weight; Calcium; Celiac Disease; Diet Therapy; Dwarfism; Female; Folic Acid; Humans; Iron; Malabsorption Syndromes; Radiography; Vitamin K

Topics: Ascorbic Acid; Blood Glucose; Blood Proteins; Bone Diseases; Celiac Disease; Cholesterol; Esophageal Diseases; Fats; Feces; Female; Gastrectomy; Gastrointestinal Motility; Glucose Tolerance Test; Hemostasis; Humans; Intestinal Absorption; Iodine; Jejunum; Malabsorption Syndromes; Male; Nitrogen; Radiography; Vitamin A Deficiency; Vitamin K; Water-Electrolyte Balance; Xylose

Topics: Anemia; Celiac Disease; Diet Therapy; Dwarfism; Edema; Glutens; Humans; Hypocalcemia; Hypokalemia; Hypoproteinemia; Hypoprothrombinemias; Kidney Diseases; Malabsorption Syndromes; Osteomalacia; Vitamin K

Topics: Calcium; Calcium, Dietary; Celiac Disease; Diet; Diet Therapy; Drug Therapy; Glutens; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Osteitis Fibrosa Cystica; Potassium; Sprue, Tropical; Vitamin D; Vitamin K; Vitamins

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Anorexia Nervosa; Ascorbic Acid; Avitaminosis; Celiac Disease; Deficiency Diseases; Diet; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Sprue, Tropical; United Kingdom; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins; Vomiting

Topics: Barium Sulfate; Celiac Disease; Colonic Diseases; Congenital Abnormalities; Constriction, Pathologic; Dietary Fats; Ecchymosis; Glucose Tolerance Test; Humans; Infant; Intestinal Obstruction; Jejunum; Malabsorption Syndromes; Pathology; Rotation; Surgical Procedures, Operative; Vitamin A; Vitamin K; Xylose

Topics: Celiac Disease; Crohn Disease; Diet; Diet Therapy; Enteritis; Glutens; Humans; Malabsorption Syndromes; Neuritis; Peripheral Nervous System Diseases; Sprue, Tropical; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins

Topics: Adrenal Cortex Hormones; Calcium; Calcium, Dietary; Celiac Disease; Dietary Carbohydrates; Dietary Proteins; Drug Therapy; Folic Acid; Humans; Iron; Magnesium; Malabsorption Syndromes; Sprue, Tropical; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K

Topics: Ascorbic Acid; Celiac Disease; Clinical Laboratory Techniques; Humans; Sprue, Tropical; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin K; Vitamins

Topics: Antifibrinolytic Agents; Celiac Disease; Hemorrhagic Disorders; Humans; Sprue, Tropical; Steatorrhea; Vitamin K; Vitamin K Deficiency

Topics: Celiac Disease; Humans; Sprue, Tropical; Vitamin A; Vitamin K; Vitamins

Topics: Celiac Disease; Folic Acid; Humans; Retinoids; Sprue, Tropical; Vitamin A; Vitamin B Complex; Vitamin K; Vitamins