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Detection of subclinical vitamin K deficiency in neurosurgery with PIVKA-II

Dahlberg, Sofia ; Nilsson, Caroline Ulfsdotter LU ; Kander, Thomas LU orcid and Schött, Ulf LU (2017) In Scandinavian Journal of Clinical and Laboratory Investigation 77(4). p.267-274
Abstract

Vitamin K is known for supporting the carboxylation of hepatic coagulation proteins. Levels of proteins induced by vitamin K absence for factor II (PIVKA-II) reflect hypocarboxylated prothrombin and can be used to detect subclinical vitamin K deficiency. The aim of this study was to determine the prevalence of perioperative subclinical vitamin K deficiency among neurosurgical patients using PIVKA-II and investigate the existence of any correlation to standard coagulation assays. Also, the antitumor effects of vitamin K were reviewed. Thirty-five patients undergoing brain tumor resection were included. Blood samples were drawn preoperatively, at the end of surgery and in the morning after surgery. In addition to PIVKA-II, factor II and... (More)

Vitamin K is known for supporting the carboxylation of hepatic coagulation proteins. Levels of proteins induced by vitamin K absence for factor II (PIVKA-II) reflect hypocarboxylated prothrombin and can be used to detect subclinical vitamin K deficiency. The aim of this study was to determine the prevalence of perioperative subclinical vitamin K deficiency among neurosurgical patients using PIVKA-II and investigate the existence of any correlation to standard coagulation assays. Also, the antitumor effects of vitamin K were reviewed. Thirty-five patients undergoing brain tumor resection were included. Blood samples were drawn preoperatively, at the end of surgery and in the morning after surgery. In addition to PIVKA-II, factor II and the Owren and Quick prothrombin times were analyzed. Seventeen of 35 patients had elevated PIVKA-II levels before surgery, which continued to be above normal range postoperatively. Median PIVKA-II and Owren prothrombin time (PT-INR) were increased on the morning day 1 postoperatively compared to before surgery, whereas Quick end-stage prothrombin time (EPT) decreased and factor II was unaffected. Postoperative complications were connected to high PIVKA-II increases. Positive correlations between PIVKA-II and factor II and body mass index (BMI) were found. In conclusion, PIVKA-II was increased in many patients preoperatively and then increased by the morning following surgery. Standard coagulation assays were largely non-pathological. Correlations were demonstrated between PIVKA-II and factor II and BMI. The effect of perioperative treatment with different vitamin K supplements should be investigated in future studies, as well as clinical trials evaluating their antitumor effects.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Brain neoplasm, coagulation factors, lipoproteins and cardiovascular markers, liver enzymes, neurosurgery, nutrition and malabsorption, surgery, vitamin K
in
Scandinavian Journal of Clinical and Laboratory Investigation
volume
77
issue
4
pages
8 pages
publisher
Informa Healthcare
external identifiers
  • scopus:85015703509
  • pmid:28319421
  • wos:000401554800007
ISSN
0036-5513
DOI
10.1080/00365513.2017.1303190
project
Koagulation vid kirurgi och kritisk sjukdom
language
English
LU publication?
yes
id
c1f6a739-3f5b-4ba8-b7d3-29fcc93e7802
date added to LUP
2017-04-05 12:37:34
date last changed
2024-02-29 12:25:22
@article{c1f6a739-3f5b-4ba8-b7d3-29fcc93e7802,
  abstract     = {{<p>Vitamin K is known for supporting the carboxylation of hepatic coagulation proteins. Levels of proteins induced by vitamin K absence for factor II (PIVKA-II) reflect hypocarboxylated prothrombin and can be used to detect subclinical vitamin K deficiency. The aim of this study was to determine the prevalence of perioperative subclinical vitamin K deficiency among neurosurgical patients using PIVKA-II and investigate the existence of any correlation to standard coagulation assays. Also, the antitumor effects of vitamin K were reviewed. Thirty-five patients undergoing brain tumor resection were included. Blood samples were drawn preoperatively, at the end of surgery and in the morning after surgery. In addition to PIVKA-II, factor II and the Owren and Quick prothrombin times were analyzed. Seventeen of 35 patients had elevated PIVKA-II levels before surgery, which continued to be above normal range postoperatively. Median PIVKA-II and Owren prothrombin time (PT-INR) were increased on the morning day 1 postoperatively compared to before surgery, whereas Quick end-stage prothrombin time (EPT) decreased and factor II was unaffected. Postoperative complications were connected to high PIVKA-II increases. Positive correlations between PIVKA-II and factor II and body mass index (BMI) were found. In conclusion, PIVKA-II was increased in many patients preoperatively and then increased by the morning following surgery. Standard coagulation assays were largely non-pathological. Correlations were demonstrated between PIVKA-II and factor II and BMI. The effect of perioperative treatment with different vitamin K supplements should be investigated in future studies, as well as clinical trials evaluating their antitumor effects.</p>}},
  author       = {{Dahlberg, Sofia and Nilsson, Caroline Ulfsdotter and Kander, Thomas and Schött, Ulf}},
  issn         = {{0036-5513}},
  keywords     = {{Brain neoplasm; coagulation factors; lipoproteins and cardiovascular markers; liver enzymes; neurosurgery; nutrition and malabsorption; surgery; vitamin K}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{4}},
  pages        = {{267--274}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Clinical and Laboratory Investigation}},
  title        = {{Detection of subclinical vitamin K deficiency in neurosurgery with PIVKA-II}},
  url          = {{http://dx.doi.org/10.1080/00365513.2017.1303190}},
  doi          = {{10.1080/00365513.2017.1303190}},
  volume       = {{77}},
  year         = {{2017}},
}