The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Blood Sampling and Laboratory Examinations
2.3. Assessment of Dietary Vitamin K Intake
2.4. Supplementation of Vitamin K
2.5. Assessment of Bone Quality at the Calcaneus
2.6. Statistical Analyses
2.7. Ethics Statement
3. Results
3.1. Patients’ Characteristics
3.2. Enteral Tube Feeding
3.3. Vitamin K Status
3.4. Effect of Vitamin K Supplementation on PIVKA-II Levels
3.5. Effect of Vitamin K Supplementation on BMD Parameters at the Calcaneus
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Elevated (n = 13) | Normal (n = 7) | |
---|---|---|
PIVKA-II (mAU/mL) (Normal Range < 40) | 616 ± 194 (44–2080) | 28 ± 3 (21–39) |
Blood coagulation test | ||
Prothrombin time (s) (normal range: 10.0–13.0) | 13.9 ± 1.4 | 11.9 ± 0.3 |
PT (%) (normal range: 80–120) | 78 ± 5 | 91 ± 5 |
PT-INR (normal range: 1.00–1.40) | 1.25 ± 0.14 | 1.10 ± 0.05 |
aPTT (s) (normal range: 24.5–33.5) | 35.9 ± 1.7 | 35.8 ± 1.6 |
Fibrinogen (mg/dL) (normal range: 200–400) | 316 ± 27 | 332 ± 19 |
AT-III (%) (normal range: 5–125) | 109 ± 4 | 113 ± 4 |
Duration of tube feeding (years) | 10 ± 2 | 11.9 ± 0.3 |
Daily nutritional intake | ||
Vitamin K intake (µg/day) | 53 ± 5 | 70 ± 9 |
Percentile of recommended daily vitamin K intake (%) | 36.7 ± 2.6 | 46.5 ± 6.2 |
Energy intake (kcal/day) | 950 ± 50 | 970 ± 102 |
Percentile of recommended daily energy intake (%) | 43.0 ± 3.1 | 44.1 ± 5.3 |
Protein (g/day) | 45 ± 3 | 45 ± 4 |
Fat (g/day) | 29 ± 10 | 29 ± 4 |
Carbohydrate (g/day) | 133 ± 10 | 127 ± 15 |
Nutritional parameters | ||
Albumin (g/dL) | 3.6 ± 0.1 * | 3.8 ± 0.2 |
Transferrin (mg/dL) | 225 ± 10 | 220 ± 9 |
Transthyretin (mg/dL) | 29 ± 2 | 31 ± 3 |
Retinol binding protein (mg/dL) | 7.0 ± 0.9 | 6.4 ± 1.0 |
Ceruloplasmin (mg/dL) | 32.7 ± 1.9 | 33.5 ± 2.6 |
Total cholesterol (mg/dL) | 164 ± 7 | 175 ± 9 |
Triglyceride (mg/dL) | 124 ± 21 | 79 ± 13 |
HDL cholesterol (mg/dL) | 58 ± 6 | 66 ± 6 |
LDL cholesterol (mg/dL) | 81 ± 6 | 92 ± 8 |
Cholinesterase (U/L) | 312 ± 13 | 360 ± 19 |
Total lymphocyte count (/μL) | 2003 ± 356 | 2064 ± 399 |
C-reactive protein (mg/dL) | 0.56 ± 0.14 | 0.48 ± 0.17 |
Liver and kidney functions | ||
AST (IU/L) | 23 ± 2 | 17 ± 2 |
ALT (IU/L) | 21 ± 3 | 16 ± 1 |
γ-GTP (IU/L) | 81 ± 14 | 56 ± 13 |
ALP (IU/mL) | 136 ± 15 | 99 ± 8 |
LDH (U/L) | 159 ± 11 | 145 ± 20 |
CPK (U/L) | 57 ± 12 | 72 ± 20 |
Creatinine (mg/dL) | 0.58 ± 0.16 | 0.56 ± 0.12 |
Blood urea nitrogen (mg/dL) | 17.3 ± 6.2 | 17.4 ± 4.0 |
Elevated (n = 9) | Normal (n = 11) | |
---|---|---|
Osteocalcin (ng/mL) | 30.2 ± 11.7 | 22.1 ± 9.9 |
ucOC (ng/mL) (normal range < 4.5 ng/mL) | 7.59 ± 3.12 | 2.44 ± 1.08 |
Blood coagulation test | ||
Prothrombin time (s) (normal range: 10.0–13.0) | 14.0 ± 6.4 | 12.2 ± 0.8 |
PT (%) (normal range: 80–120) | 82 ± 25 | 86 ± 14 |
PT-INR (normal range: 1.00–1.40) | 1.28 ± 0.64 | 1.08 ± 0.08 |
aPTT (s) (normal range: 24.5–33.5) | 35.5 ± 7.9 | 35.1 ± 3.2 |
Fibrinogen (mg/dL) (normal range: 200–400) | 344 ± 76 | 309 ± 93 |
AT-III (%) (normal range: 5–125) | 113 ± 13 | 110 ± 12 |
Duration of tube feeding (years) | 12 ± 8 | 13 ± 7 |
Daily nutritional intake | ||
Vitamin K intake (µg/day) | 55 ± 25 | 61 ± 18 |
Percentile of recommended daily vitamin K intake (%) | 39.0 ± 14.2 | 41.0 ± 12.2 |
Energy intake (kcal/day) | 947 ± 205 | 970 ± 220 |
Protein (g/day) | 48 ± 12 | 43 ± 12 |
Fat (g/day) | 22 ± 12 | 36 ± 39 |
Carbohydrate (g/day) | 136 ± 29 | 132 ± 37 |
Nutritional parameters | ||
Albumin (g/dL) | 3.7 ± 0.4 | 3.6 ± 0.4 |
Transferrin (mg/dL) | 221 ± 36 | 225 ± 31 |
Transthyretin (mg/dL) | 31 ± 8 | 31 ± 3 |
Retinol binding protein (mg/dL) | 7.4 ± 4.2 | 6.2 ± 1.9 |
Ceruloplasmin (mg/dL) | 34.8 ± 8.0 | 30.8 ± 4.7 |
Total cholesterol (mg/dL) | 157 ± 12 | 175 ± 9 |
Triglyceride (mg/dL) | 136 ± 83 | 85 ± 36 |
HDL cholesterol (mg/dL) | 55 ± 22 | 66 ± 14 |
LDL cholesterol (mg/dL) | 75 ± 12 | 93 ± 24 |
Cholinesterase (U/L) | 352 ± 62 | 310 ± 35 |
Total lymphocyte count (/μL) | 2376 ± 1277 | 1737 ± 1010 |
C-reactive protein (mg/dL) | 0.60 ± 0.60 | 0.47 ± 0.35 |
Liver and kidney functions | ||
AST (IU/L) | 21 ± 10 | 21 ± 6 |
ALT (IU/L) | 20 ± 10 | 19 ± 7 |
γ-GTP (IU/L) | 72 ± 57 | 72 ± 35 |
ALP (IU/mL) | 124 ± 67 | 112 ± 32 |
LDH (U/L) | 150 ± 42 | 154 ± 42 |
CPK (U/L) | 53 ± 48 | 59 ± 39 |
Creatinine (mg/dL) | 0.64 ± 0.69 | 0.51 ± 0.28 |
Blood urea nitrogen (mg/dL) | 18.7 ± 18.1 | 16.3 ± 13.6 |
MK-4 Treatment | T-Score | Z-Score | ||
---|---|---|---|---|
Before | After | Before | After | |
Yes (n = 4) | −5.5 ± 1.0 | −6.1 ± 0.9 | −3.9 ± 1.3 | −5.0 ± 2.1 |
No (n = 6) | −6.3 ± 1.0 | −6.4 ± 0.8 | −4.6 ± 1.2 | −4.6 ± 1.1 |
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Ohmori, H.; Kato, A.; Shirai, Y.; Fukano, R.; Nagae, A.; Yamasaki, M.; Komenaka, J.; Imamura, E.; Kumode, M.; Miyachi, T. The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding. Nutrients 2023, 15, 4525. https://doi.org/10.3390/nu15214525
Ohmori H, Kato A, Shirai Y, Fukano R, Nagae A, Yamasaki M, Komenaka J, Imamura E, Kumode M, Miyachi T. The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding. Nutrients. 2023; 15(21):4525. https://doi.org/10.3390/nu15214525
Chicago/Turabian StyleOhmori, Hiromitsu, Akihiko Kato, Yuka Shirai, Reiji Fukano, Akiko Nagae, Masami Yamasaki, Junko Komenaka, Eiji Imamura, Masao Kumode, and Takafumi Miyachi. 2023. "The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding" Nutrients 15, no. 21: 4525. https://doi.org/10.3390/nu15214525