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Assessment of vitamin K status of the newborn infant
R von Kries1, F R Greer, J W Suttie
1Department of Pediatrics, University of Wisconsin, Madison.
Insights
This review covers methods to assess vitamin K status in infants, focusing on deficiency states. It details lab tests for coagulation factors, vitamin K1, and abnormal prothrombin (PIVKA-II).
Area of Science:
- Biochemistry
- Pediatrics
- Nutritional Science
Background:
- Vitamin K deficiency can occur in human infants.
- Accurate assessment of vitamin K status is crucial for infant health.
- Existing methods require comprehensive review and comparison.
Purpose of the Study:
- To review current knowledge on assessing vitamin K status in infants.
- To discuss various laboratory measures for evaluating vitamin K status.
- To highlight the clinical relevance of these assessments in pediatrics.
Main Methods:
- Review of laboratory measures for functional assessment of vitamin K-dependent coagulation factors.
- Quantitative assay for vitamin K1 (phylloquinone).
- Discussion of four methods for measuring abnormal prothrombin (protein induced by vitamin K absence - PIVKA-II).
Main Results:
- Laboratory measures for coagulation factors and vitamin K1 assay are available.
- PIVKA-II measurement offers insights into vitamin K deficiency.
- Additional methods like serum osteocalcin and urinary gamma-carboxyglutamic acid provide further assessment avenues.
Conclusions:
- Multiple methods exist for assessing infant vitamin K status, including coagulation tests, vitamin K1 assays, and PIVKA-II.
- These assessments are vital for identifying and managing vitamin K deficiency in infants.
- Further research into the vitamin K cycle enzymes may offer additional diagnostic tools.
Abstract:
This article reviews our current knowledge of the assessment of vitamin K status in the human infant, where a deficiency state has been described. Laboratory measures for the functional assessment of vitamin K-dependent coagulation factors as well as the quantitative assay for vitamin K1 (phylloquinone) are reviewed. In addition, four different methods of measuring abnormal prothrombin, a protein induced by vitamin K absence (PIVKA-II), and its use in clinical pediatrics are discussed. Finally, additional methods are briefly described for assessing vitamin K status, including serum osteocalcin, urinary excretion of gamma-carboxyglutamic acid, and deficiencies of the enzymes necessary for the regeneration of phylloquinone in the so-called vitamin K cycle.
