Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery. Issue 6 (11th December 2014)

• Record Type: Journal Article
• Authors: Ewang‐Emukowhate, M.; Harrington, D. J.; Botha, A.; McGowan, B.; Wierzbicki, A. S.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 6(2015)
• Page Start: 638
• Page End: 642
• Publication Date: 2014-12-11
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12594
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12594-abs-0001"> <title>Summary</title> <sec id="ijcp12594-sec-0001" sec-type="section"> <title>Background</title> <p>Micronutrient deficiencies occur in morbidly obese patients. The aim of this study was to assess vitamin deficiencies prior to bariatric surgery including vitamin K about which there is little data in this population.</p> </sec> <sec id="ijcp12594-sec-0002" sec-type="section"> <title>Methods</title> <p>A prospective assessment of 118 consecutive patients was performed. Clinical allied with haematological and biochemical variables were measured. Micronutrients measured included vitamins K<sub>1</sub>, PIVKA‐II (protein‐induced in vitamin K absence factor II), vitamin D, vitamin B<sub>12</sub> (holotranscobalamin), iron, transferrin and folate.</p> </sec> <sec id="ijcp12594-sec-0003" sec-type="section"> <title>Results</title> <p>Patients were aged 49 ± 11 [mean (SD, standard deviation)] years, body mass index (BMI) 50 ± 8 kg/m<sup>2</sup>, 66% female and 78% Caucasian. Hypertension was present in 47% and type 2 diabetes in 32%. Vitamin D supplements had been prescribed in 8%. Micronutrient insufficiencies were found for vitamin K (40%), vitamin D (92%) and vitamin B<sub>12</sub> (25%), and also iron (44%) and folate (18%). Normocalcaemic vitamin D insufficiency with secondary hyperparathyroidism was present in 18%. Iron and transferrin levels were associated with age, sex and estimated glomerular filtration rate. Vitamin K levels were associated with age, and inversely with BMI and diabetes mellitus; and PIVKA‐II with smoking, triglycerides and liver function markers. Vitamin D levels were associated with statin use and prescription of supplements and inversely with BMI. Vitamin B<sub>12</sub> levels were associated with ethnicity and HbA<sub>1c</sub>.</p> </sec> <sec id="ijcp12594-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Micronutrient status shows differing relationships with age, gender and BMI. Vitamin K insufficiency was present in 40% and not related to deficiencies in other vitamins or micronutrients. Vitamin D and vitamin K supplementation should be considered prebariatric surgery in patients with diabetes or severe insulin resistance.</p> </sec> </abstract>