Among the individuals at risk for a vitamin K deficiency are pregnant women and babies, the elderly, the critically ill, and those suffering from addictions. Doctors may order a blood clotting test to determine if an individual is deficient in vitamin K. Prothrombin time is a marker used to detect vitamin K deficiency.
CF
The everyday use of antibiotics is a significant cause of Vitamin K deficiency in CF patients. This condition also results from a decreased production of the CFTR protein, a chloride ion channel. This protein is required for the proper function of different tissues, such as the sweat glands, mucus glands, and digestive juices. CF patients also have higher PIVKA-II concentrations than healthy subjects.
Although vitamin K deficiency is rare in CF patients, it can cause severe complications. In some cases, vitamin K deficiency affects the liver or bones, although its role in bone development is unclear. In CF, bone deficiency is a significant risk factor for amputations and limb amputations. However, vitamin K deficiency may increase the risk of osteopenia.
Pancreatic insufficiency
There is no clear definition of vitamin k deficiency in the pancreas, but exocrine pancreatitis is associated with fat-soluble vitamin deficiency in humans. The pancreatic enzyme phospholipase A2 is essential for the hydrolysis of phospholipids, which are important components of the membrane of lipid-containing micelles in the intestine.
Although serum vitamin K levels are not routinely measured in commercial laboratories, they can be determined by measuring the fat-soluble vitamins A, D, E, and C. In a previous report, EPI-associated coagulopathy resolved after pancreatic enzyme replacement therapy. The authors noted that the levels of fat-soluble vitamins increased in the blood after pancreatic enzyme replacement. The study also found that the patient’s vitamin D levels improved following pancreatic enzyme replacement therapy.
CF patients
The majority of CF centres routinely administer vitamins A, D and E to their patients. Supplementation of vitamin K is generally prescribed if clinical deficiencies are detected during routine investigations. However, the lack of consensus on the appropriate dosing regimen of vitamin K in CF patients suggests that only high doses may normalise vitamin K levels. For this reason, ongoing supplementation is recommended for patients with CF.
There are several potential causes of vitamin k deficiency in CF patients. One of the earliest causes of bleeding in infancy is CF, but doctors should consider a CF diagnosis if it is present within the first year of life. Moreover, vitamin K deficiency may contribute to developing a thrombophilic state in CF patients, although further research is needed to determine precisely what role vitamin K plays in CF.
CF patients with low factor VII activity
The genetics of factor VII activity (FVII) are inherited from both parents and can be affected at any age. The condition is also referred to as Alexander’s disease. CF patients with low factor VII activity are more susceptible to vitamin k deficiency, which can lead to severe bleeding. However, some genetic conditions have low levels of FVII in the blood.
Vitamin K deficiency is common in CF patients who are unsupplemented and have pancreatic insufficiency. Those with CF-associated liver disease are at greater risk. All CF patients with pancreatic insufficiency should be routinely supplemented with vitamin K. Whether or not patients with CF experience steatorrhea or have a history of antibiotic use should not influence vitamin K supplementation.
CF patients with low phylloquinone
Vitamin K deficiency is a common complication for cystic fibrosis (CF) patients and can be prevented by consuming a high-quality infant formula enriched with the nutrient. Infants with CF are screened for CF using a newborn screening test, which detects the disease before it has symptoms and develops.
In adults with CF, a study by Beker et al. evaluated the impact of oral phylloquinone supplementation on vitamin K levels in CF patients. They measured the concentrations of osteocalcin, PIVKA-II, and phylloquinone. The authors looked at both patients with CF and those with pancreatic insufficiency. Therefore, they suggested that a daily dose of 100-400 mg of phylloquinone is appropriate for CF patients with normal fat absorption.
CF patients with low menaquinone
While Vitamin K has traditionally been seen as a hemostasis vitamin, recent research has shown that it has new functions. Vitamin K is an important precursor of bone proteins, such as osteocalcin and matrix g-carboxyglutamic acid protein. The role of vitamin K in bone growth and mineralization is still not fully understood, but deficiencies in CF patients could have detrimental effects on skeletal development.
In CF patients with low menaquinone levels, there is a risk of vitamin k deficiency, as the bodies do not produce enough of this compound. Fortunately, the body can produce the vitamin K it needs from other sources, including fermented foods and animal livers. However, the production of menaquinones is still not fully understood, and the exact contribution of bacterial synthesis remains a mystery.