Bioavailability of phylloquinone from an intravenous lipid emulsion.
This randomized, controlled study evaluated the bioavailability of phylloquinone from an intravenous lipid emulsion. A mild vitamin K deficiency was induced in 12 healthy adult men and women by dietary restriction of phylloquinone (40 microg/d, days 1-11) and by administration of warfarin (1.0 mg/d, days 5-11). On day 11, subjects received a 500-mL intravenous solution of either lipid or saline, both of which contained 154 microg phylloquinone. Bioavailability was assessed by serial measurements of plasma phylloquinone, vitamin K1-2,3-epoxide. PIVKA-II (proteins induced by vitamin K absence or antagonists-II), and percentage undercarboxylated osteocalcin. As a result of vitamin K deficiency and minidose warfarin, vitamin K1-2,3-epoxide, PIVKA-II, and percentage undercarboxylated osteocalcin increased significantly between days 1 and 11 (P = 0.05, 0.016, and 0.001, respectively). With the infusions, plasma phylloquinone increased in both groups (P = 0.001). After the infusions vitamin K,-2,3-epoxide decreased in both groups (P = 0.002). Changes in plasma phylloquinone and vitamin K1-2,3-epoxide were no different in the two groups (mean areas under the curves +/- SEM: 116+/-13 nmol x h/L for the saline group and 102+/-20 nmol x h/L for the lipid group for phylloquinone; 38.6+/-7.5 nmol x h/L for the saline group and 31.3+/-9.0 nmol x h/L for the lipid group for vitamin K1-2,3-epoxide). PIVKA-II decreased significantly from baseline values (P = 0.005) in both groups after the infusions. Intravenous lipid reversed the effects of minidose warfarin and of dietary restriction of phylloquinone on hemostasis and vitamin K nutritional status. This reversal was no different from that seen with the infusion of phylloquinone in a saline solution.
Camilo
M E
ME
Vitamin K Laboratory, The Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, USA.
Jatoi
A
A
O'Brien
M
M
Davidson
K
K
Sokoll
L
L
Sadowski
J A
JA
Mason
J B
JB
D000328:Adult; D001682:Biological Availability; D015415:Biomarkers; D004032:Diet; D005217:Fat Emulsions, Intravenous; D005260:Female; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood; D011498:Protein Precursors / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D010837:Vitamin K 1 / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics*; D014813:Vitamin K Deficiency / Q000139:chemically induced / Q000378:metabolism; D014859:Warfarin
D015415:Biomarkers; D005217:Fat Emulsions, Intravenous; D011498:Protein Precursors; D015675:Osteocalcin; C016186:vitamin K1 oxide; C008208:acarboxyprothrombin; D014859:Warfarin; D010837:Vitamin K 1; D011516:Prothrombin