Prevalence of vitamin K and vitamin D deficiency in patients with hepatobiliary and pancreatic disorders

Date

2009

Authors

Fisher, Leon
Byrnes, Elizabeth
Fisher, Alex

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

Little is known about the role of fat-soluble vitamins K and D in liver function and bone metabolism in biliary and pancreatic diseases associated with cholestasis and/or fat malabsorption. The aim of this study was to determine vitamin K of bone, vitamin D and parathyroid hormone status in patients with biliary and pancreatic disorders. In 90 consecutive patients (mean ± SD age, 65.5 ± 17.7 years; 45 females) undergoing endoscopic retrograde cholangiopancreatography (68 with choledocholithiasis, 14 with other benign condition, and 8 with cholangiopancreatic cancers) fasting concentrations of carboxylated (cOC) and undercarboxylated osteocalcin (ucOC), 25-hydroxyvitamin D, calcium, phosphorus, magnesium, prothrombin time, liver function tests, lipase, and creatinine were measured. Vitamin D deficiency (25-hydroxyvitamin D <50 nmol/L) was found in 45.6% of patients and elevated parathyroid hormone levels in 27.8%. The ratio ucOC/cOC (index of vitamin K deficiency) was above 20% in 50.6% of patients, above 30% in 31%, and above 50% in 18.4%. Hyperbilirubinemia was a significant independent predictor of low cOC (odds ratio [OR], 11.6; 95% confidence interval [CI], 1.9-59.4; P = .07). The ratio ucOC/cOC positively correlated with alanine aminotransferase levels (r = 0.410; P < .001). Elevated γ-glutamyltransferase (>180 U/L) and international normalized ratio (>1.1) levels were significant independent predictors of ucOC/cOC greater than 30% after adjustment for other covariants (OR, 5.5; 95% CI, 1.2-25.2; P = .027, and OR, 3.1; 95% CI, 1.1-8.8; P = .036, respectively). This study demonstrates that vitamin K and vitamin D deficiencies are common in patients undergoing endoscopic retrograde cholangiopancreatography. Liver dysfunction is associated with and predictive of vitamin K deficiency of bone and decreased production of osteocalcin, indicating the need for appropriate supplementation. Crown

Description

Keywords

Keywords: 25 hydroxyvitamin D; alanine aminotransferase; bisphosphonic acid derivative; calcium; creatinine; gamma glutamyltransferase; magnesium; osteocalcin; phosphorus; prednisolone; thyroxine; triacylglycerol lipase; ursodeoxycholic acid; vitamin D; vitamin K g ERCP; Humans; Osteocalcin; Parathyroid hormone; Vitamin D; Vitamin K

Citation

Source

Nutrition Research: an international publication for nutrition to advance food and life science research

Type

Journal article

Book Title

Entity type

Access Statement

License Rights

DOI

10.1016/j.nutres.2009.09.001

Restricted until

2037-12-31