title: Protein-calorie malnutrition does not predict subtle vitamin K depletion in hospitalized patients.
abstract: OBJECTIVE
  Recent studies suggest that subtle vitamin K depletion has far-reaching consequences. As this entity is not associated with prothrombin time elevation, it is important to determine whether alternate methods can help identify it. We investigated subtle vitamin K depletion in a hospital setting and determined whether protein calorie malnutrition predicts its presence.
  
  
  METHODS
  Using a high-pressure liquid chromatography (HPLC) assay of plasma phylloquinone and a food frequency questionnaire for phylloquinone intake, we examined the phylloquinone status of 27 hospitalized patients with normal coagulation parameters, no liver disease, and no recent warfarin use. We assessed protein-calorie nutritional status with Reilly's criteria and anthropometrics.
  
  
  RESULTS
  51% of patients (95% CI = 31% to 70%) had evidence of subtle vitamin K depletion as defined by a subnormal plasma phylloquinone concentration. Patients whose phylloquinone intake was less than the Recommended Daily Allowance (RDA) over the preceding year had lower plasma phylloquinone concentrations when compared to other patients: median (range) 0.106 nmol/l (0.022-0.461) versus 0.301 nmol/l (0.067-3.928), respectively (P = 0.023). Plasma phylloquinone concentrations were no different, however, between well-nourished and malnourished patients: median (range) 0.245 nmol/l (0.022-0.522) versus 0.188 nmol/l (0.067-3.928), respectively (P=0.782).
  
  
  CONCLUSIONS
  Subtle vitamin K depletion is common among hospitalized patients and protein-calorie malnutrition does not predict its presence.
authors.affiliation: New England Medical Center, Jean Mayer USDA Human Nutritional Research Center on Aging at Tufts University, Boston, Massachusetts, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jatoi
authors.forename: C
authors.initials: C
authors.lastname: Lennon
authors.forename: M
authors.initials: M
authors.lastname: O'Brien
authors.forename: S L
authors.initials: SL
authors.lastname: Booth
authors.forename: J
authors.initials: J
authors.lastname: Sadowski
authors.forename: J B
authors.initials: JB
authors.lastname: Mason
mesh_terms: D000328:Adult; D000886:Anthropometry; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000175:diagnosis*; D011517:Prothrombin Time; D012709:Serum Albumin / Q000032:analysis; D011795:Surveys and Questionnaires; D010837:Vitamin K 1 / Q000008:administration & dosage / Q000097:blood; D014813:Vitamin K Deficiency / Q000175:diagnosis*
chemical_list: D012709:Serum Albumin; D010837:Vitamin K 1