vitamin-k-semiquinone-radical and Short-Bowel-Syndrome

Bone loss has been established as a major extra-intestinal complication of short bowel syndrome (SBS). The purpose of this study was to correlate bone mineral density (BMD) with body mass index (BMI), serum vitamin and mineral levels in patients with SBS.. The study was conducted on 13 patients (8 male and 5 female, 54.7 ± 11.4 years) with SBS (residual small bowel length of 10 to 100 cm). We determined the food ingestion, anthropometry, serum levels of vitamins C, A, D, E and K, as well as serum and urinary levels of phosphorus and calcium. BMD was measured by dual-energy x-ray absorptiometry (DXA).. Osteopenia and osteoporosis was diagnosed in all but one SBS patient. Serum levels of vitamin D were low in all volunteers. Sixty-one percent of patients had vitamin E deficiency; hypovitaminosis A and C occurred in one subject. BMI and C, E and K vitamin serum levels correlated with T-score of BMD.. Osteopenia and osteoporosis were common in SBS patients. There was a correlation between BMD and the serum levels of vitamins C, E and K, an indicative that such vitamins may influence bone health.

Topics: Absorptiometry, Photon; Adult; Aged; Ascorbic Acid; Avitaminosis; Body Mass Index; Bone Density; Bone Diseases, Metabolic; Calcium; Cross-Sectional Studies; Energy Intake; Female; Hospitalization; Humans; Male; Middle Aged; Osteoporosis; Phosphorus; Reference Values; Short Bowel Syndrome; Time Factors; Vitamin E; Vitamin K

Available evidence suggests that patients with short bowel syndrome (SBS) might be at risk of vitamins A, D, E and B(1) deficiency. However, there is little clinical data describing the vitamin K status. Therefore, in the present study we aimed to assess the body resources of vitamin K in a subset of SBS patients.. The study comprised 33 patients aged 1 month to 16 years. PIVKA-II concentrations were determined in all subjects.. In all studied subjects, coagulation parameters were normal. PIVKA-II levels indicative of vitamin K deficiency was found in 3 (9.1%) SBS patients. One patient had been receiving an additional intravenous vitamin K dose of 5 mg/week. In all SBS patients with cirrhosis and cholestasis, PIVKA-II concentrations were low (<2 ng/ml). However, all patients with severe liver disease were receiving vitamin K several times a month.. Vitamin K deficiency may appear in SBS patients.

Topics: Adolescent; Antifibrinolytic Agents; Biomarkers; Blood Coagulation; Child; Child, Preschool; Cholestasis; Female; Humans; Infant; Liver Cirrhosis; Male; Protein Precursors; Prothrombin; Short Bowel Syndrome; Vitamin K; Vitamin K Deficiency; Vitamins

To determine whether warfarin can be safely administered to children who require long-term total parenteral nutrition (TPN), for the purpose of preventing central venous access device (CVAD)-related thrombosis.. A prospective cohort study was conducted of 8 children with short-gut syndrome or small intestinal anomalies. All patients received oral anticoagulant therapy (warfarin) managed by the hematology department at a tertiary pediatric center. Data collected included demographic details, nutritional intake, age, weight, history of deep vein thrombosis, number and functional duration of CVADs, warfarin requirements, and adverse event rates.. A total of 15.2 warfarin years were studied prospectively. The target therapeutic range was achieved 51.1% of time. The mean dose of warfarin required to achieve the target therapeutic range (international normalized ratio) of 2.0 to 3.0 was 0.33 mg/kg/d. The mean duration between warfarin monitoring tests was 6.6 days. The median vitamin K intake per patient was 0.367 mg/kg/d (range: 0.018-2.85 mg/kg/d). Before commencing anticoagulant therapy, the mean CVAD duration was 160.9 days. Concomitant warfarin therapy was associated with a mean CVAD duration of 351.7 days. There were no major bleeding events, and no clinical extension of thrombosis was observed.. This is the first published study to report uniform warfarin prophylaxis for CVADs in children. Warfarin therapy can be administered safely in children who require long-term TPN. Warfarin prophylaxis seems to prolong CVAD survival.

Topics: Adolescent; Anticoagulants; Catheterization, Central Venous; Child; Child, Preschool; Cohort Studies; Congenital Abnormalities; Drug Evaluation; Female; Hemorrhage; Humans; International Normalized Ratio; Intestine, Small; Male; Parenteral Nutrition, Total; Prospective Studies; Safety; Short Bowel Syndrome; Thrombosis; Vitamin K; Warfarin

Patients with extensive small-bowel resection may experience malabsorption and nutrient deficiencies. We evaluated the ability to absorb fat and fat-soluble vitamins in a short-gut patient. For 18 wk after stopping intravenous lipid, while consuming a low-lactose, low-fat diet, he exhibited no clinical manifestations of essential fatty acid deficiency (EFAD). Serum 20:4n-6 (20:4 omega-6) and 18:2n-6 fatty acid concentrations were normal, whereas the concentration of 20:3n-9 remained less than or equal to 0.1% of total serum fatty acids. Although serum vitamin A was normal, beta-carotene was undetectable despite oral supplementation. Prothrombin time was elevated until parenteral vitamin K was given. This patient has fat absorption adequate to prevent EFAD but inadequate absorption of fat-soluble vitamins. In patients with short bowel, the requirements for parenteral lipids and fat-soluble vitamins should be determined independently.

Topics: Absorption; Adult; Avitaminosis; beta Carotene; Carotenoids; Fats; Fatty Acids, Essential; Humans; Infusions, Parenteral; Lipids; Male; Prothrombin Time; Short Bowel Syndrome; Solubility; Vitamin K; Vitamin K Deficiency