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Vitamin K deficiency
Classification and external resources
ICD-10 E56.1
ICD-9 269.0
eMedicine med/2385
MeSH D014813

Vitamin K deficiency is a form of avitaminosis resulting from insufficient vitamin K.

Contents

[edit] Causes

Vitamin K-deficiency may occur by disturbed intestinal uptake (such as would occur in a bile duct obstruction), by therapeutic or accidental intake of vitamin K-antagonists or, very rarely, by nutritional vitamin K deficiency. As a result, Gla-residues are inadequately formed and the Gla-proteins are insufficiently active.

[edit] Symptoms

Symptoms include ecchymosis[1], petechiae[1], hematomas[1], oozing of blood at surgical or puncture sites, stomach pains; risk of massive uncontrolled bleeding; cartilage calcification; and severe malformation of developing bone or deposition of insoluble calcium salts in the walls of arteries.

In infants, it can cause some birth defects such as underdeveloped face, nose, bones, and fingers.[1]

[edit] Vitamin supplementation

According to a study published in the October 14, 2008 edition of PLoS Medicine, Vitamin K does not protect against age-related decreasing bone density, but may protect against fractures and cancers in postmenopausal women.[2]

Menaquinone (vitamin K2), but not phylloquinone (vitamin K1), intake is associated with reduced risk of CHD mortality, all-cause mortality and severe aortic calcification.[3][4][5]

In a cohort study in Germany (11319 men, mean follow-up time 8.6y), Menaquinone intake was associated with decreased incidence of advanced prostate cancer.[6]

[edit] Prevalence

The prevalence of vitamin K deficiency varies by geographic region.

For infants in the United States, vitamin K deficiency without bleeding may occur in as many as 50% of infants younger than 5 days old. [1] Therefore, the Committee on Nutrition of the American Academy of Pediatrics recommends that 0.5 to 1.0 mg Vitamin K1 be administered to all newborns shortly after birth. [7]

Postmenopausal and elderly women in Thailand have high risk of Vitamin K2 deficiency, compared with the normal value of young, reproductive females.[8] Current dosage recommendations for Vitamin K may be too low.[9]

The deposition of calcium in soft tissues, including arterial walls, is quite common, especially in those suffering from atherosclerosis, suggesting that Vitamin K deficiency is more common than previously thought.[10]

[edit] References

  1. ^ a b c d e Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008
  2. ^ Vitamin K Does Not Prevent Bone Density Loss, but May Prevent Fractures and Cancers Newswise, Retrieved on October 13, 2008.
  3. ^ Geleijnse JM, Vermeer C, Grobbee DE, et al. (2004). "Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study". J. Nutr. 134 (11): 3100–5. PMID 15514282. 
  4. ^ Erkkilä AT, Booth SL (2008). "Vitamin K intake and atherosclerosis". Curr. Opin. Lipidol. 19 (1): 39–42. doi:10.1097/MOL.0b013e3282f1c57f (inactive 2008-06-25). PMID 18196985. 
  5. ^ Wallin R, Schurgers L, Wajih N (2008). "Effects of the blood coagulation vitamin K as an inhibitor of arterial calcification". Thromb. Res. 122: 411. doi:10.1016/j.thromres.2007.12.005. PMID 18234293. 
  6. ^ Nimptsch K, Rohrmann S, Linseisen J (April 2008). "Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg)". Am. J. Clin. Nutr. 87 (4): 985–92. PMID 18400723. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400723. 
  7. ^ "Controversies concerning vitamin K and the newborn. American Academy of Pediatrics Committee on Fetus and Newborn". Pediatrics 112 (1 Pt 1): 191–2. July 2003. PMID 12837888. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=12837888. 
  8. ^ Bunyaratavej N (2007). "[Experience of vitamin K2 in Thailand]" (in Japanese). Clin Calcium 17 (11): 1752–60. doi:CliCa071117521760 (inactive 2008-06-25). PMID 17982197. 
  9. ^ Adams J, Pepping J (2005). "Vitamin K in the treatment and prevention of osteoporosis and arterial calcification". Am J Health Syst Pharm 62 (15): 1574–81. doi:10.2146/ajhp040357. PMID 16030366. 
  10. ^ Berkner KL, Runge KW (2004). "The physiology of vitamin K nutriture and vitamin K-dependent protein function in atherosclerosis". J. Thromb. Haemost. 2 (12): 2118–32. doi:10.1111/j.1538-7836.2004.00968.x. PMID 15613016. http://www.blackwell-synergy.com/doi/full/10.1111/j.1538-7836.2004.00968.x. 



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