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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.

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author
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
  • scopus:85019549179
  • wos:000401554800007
ISSN
0036-5513
DOI
10.1080/00365513.2017.1303190
language
English
LU publication?
yes
id
c1f6a739-3f5b-4ba8-b7d3-29fcc93e7802
date added to LUP
2017-04-05 12:37:34
date last changed
2018-02-11 10:19:38
@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},
  keyword      = {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},
  volume       = {77},
  year         = {2017},
}