Detection of subclinical vitamin K deficiency in neurosurgery with PIVKA-II
Dahlberg, Sofia ; Nilsson, Caroline Ulfsdotter LU ; Kander, Thomas LU
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.
(Less)
- author
- Dahlberg, Sofia
; Nilsson, Caroline Ulfsdotter
LU
; Kander, Thomas
LU
and Schött, Ulf
LU
- organization
- publishing date
- 2017-03-20
- 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
-
- pmid:28319421
- wos:000401554800007
- scopus:85015703509
- 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
- 2025-03-17 15:45:28
@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}},
}