Enteral nutrition and antibiotic use increase the risk for vitamin K deficiency in patients with severe motor and intellectual disabilities

Nagae, Akiko; Kuwabara, Akiko; Tozawa, K.; Kumode, Masao; Takeuchi, Yoshinao; Tanaka, Kiyoshi

doi:10.1016/j.clnme.2012.12.002

Cited by 3 publications

(12 citation statements)

References 17 publications

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“…The vitamin K‐dependent liver marker exceeded the upper normal range in 52% (CI 41.6–63.2%), and the vitamin K‐dependent bone marker was above the upper reference in 30% (CI 20.5–40.5%; IV low, EV moderate; Nagae et al . ).…”

Section: Resultsmentioning

confidence: 97%

“…In seven studies, both adults and children (age 0–82 years) were included (Van der Heide et al ; Petry et al ; Fellinger et al ; Van den Broek et al ; Poppes et al ; Van den Akker et al ; McGuire et al ). Eight studies included a study population that was representative for SPIMD (Gittins & Rose ; Nagae et al ; Ohwada et al ; Ohwada & Nakayama ; Van den Broek et al ; Poppes et al ; Van der Heide et al ; Petry et al ). All of the studies included both male and female.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross‐sectional studies

Timmeren

Schans

Putten

et al. 2016

J intellect Disabil Res

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross‐sectional studies

Timmeren

Schans

Putten

et al. 2016

J intellect Disabil Res

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“…Severe motor and intellectual disabilities (SMID) are characterized by severe physical and mental retardation. Japan has approximately 40,000-50,000 patients with SMID [1][2][3]. Most patients with SMID are bedridden or remain in a sitting position and have intelligence quotients (IQ) lower than 35 (Ohshima's classification, Grade 1-4) (Supplementary Figure S1) [4].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding

Ohmori,

Kato,

Shirai

et al. 2023

Nutrients

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Nutritional support is essential for patients with severe motor and intellectual disabilities (SMID) to ensure the smooth provision of medical care. These patients often require long-term tube feeding with enteral formulas, potentially leading to deficiencies in vitamins and trace elements. Additionally, frequent antibiotic use for infections often disrupts gut microbiota, inhibiting vitamin K2 production by intestinal bacteria. We assessed the serum protein induced by vitamin K absence or antagonists-II (PIVKA-II) and undercarboxylated osteocalcin (ucOC) levels to assess the vitamin K status in 20 patients with SMID (median age: 44.1 years, 11 men and 9 women) undergoing long-term tube feeding for durations ranging from 3 to 31 years. Thirteen (65%) and nine (45%) patients had elevated PIVKA-II (<40 mAU/mL) and serum ucOC levels (reference value < 4.50 ng/mL), respectively. Dietary vitamin K1 intake did not differ between patients with and without elevated PIVKA-II levels. Vitamin K2 supplementation for 3 months decreased serum PIVKA-II levels near those within the reference range. Approximately half of the patients with SMID on tube feeding had subclinical vitamin K deficiency. Further studies are needed to ascertain if long-term vitamin K2 supplementation effectively prevents vitamin K deficiency-induced hypercoagulation, osteoporosis, and vascular calcification in patients with SMID.

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mentioning

confidence: 99%

“…Reports on the vitamin K status in SMID patients is quite limited (12,13). We have previously studied the E-mail: akuwabara@rehab.osakafu-u.ac.jp vitamin K status in patients with SMID (13). A substantial percentage of patients with SMID must be kept under enteral nutrition because of their dysphagia.…”

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confidence: 99%

Nutritional Therapy with Vitamin K<sub>1</sub> Is Effective in the Improvement of Vitamin K Status and Bone Turnover Markers in Patients with Severe Motor and Intellectual Disabilities

Kuwabara

Nagae

Kitagawa

et al. 2020

J Nutr Sci Vitaminol

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We have previously reported that patients with severe motor and intellectual disabilities (SMID) have a high prevalence of vitamin K deficiency both in the liver and bone. Thus, vitamin K therapy for SMID patients should be considered. In the present study, we have studied the efficacy of nutritional therapy with vitamin K 1 for improving their vitamin K status and bone metabolism markers in patients with SMID. During the 3-mo period, 19 patients under enteral feeding received vitamin K1 treatment, the dose of which was determined to meet each subject's energy requirement. Biomarkers of vitamin K insufficiency; protein induced by vitamin K absence or antagonist-II (PIVKA-II), undercarboxylated osteocalcin (ucOC), intact osteocalcin (intact OC) and bone turnover markers (tartrate-resistant acid phosphatase-5b: TRACP-5b and bone alkaline phosphatase: BAP) were measured at baseline and post treatment. The ucOC/OC ratio was calculated as a more sensitive index than ucOC for vitamin K status in the bone. After treatment, the median vitamin K intake increased from 66 to 183 mg/d, and serum levels of PIVKA-II and ucOC/OC ratio were significantly decreased. Decrements of serum ucOC level and ucOC/OC ratio were significantly associated with vitamin K intake, indicating that both markers well reflect the dose-dependent vitamin K effects. Serum levels of BAP and TRACP-5b were significantly increased after vitamin K1 therapy. Nutritional therapy with vitamin K1 effectively improved the markers for vitamin K status and bone turnover, and was considered to be a good candidate for treatment in SMID patients.

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Enteral nutrition and antibiotic use increase the risk for vitamin K deficiency in patients with severe motor and intellectual disabilities

Cited by 3 publications

References 17 publications

Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross‐sectional studies

Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross‐sectional studies

The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding

Nutritional Therapy with Vitamin K<sub>1</sub> Is Effective in the Improvement of Vitamin K Status and Bone Turnover Markers in Patients with Severe Motor and Intellectual Disabilities

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