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Urinary excretion of vitamin k metabolites in term and preterm infants: relationship to vitamin k status and prophylaxis.
MedLine Citation:
PMID:  20814348     Owner:  NLM     Status:  In-Data-Review    
Little is known about the metabolic turnover and excretion of vitamin K in healthy newborn infants and the metabolic consequences of prophylactic regimens designed to protect against vitamin K deficiency bleeding (VKDB). We measured the excretion of two urinary metabolites (≤24 h) of vitamin K (5C- and 7C-aglycones) in term infants before (n = 11) and after (n = 5) a 1000 μg i.m. dose of vitamin K1 (K1) and in preterm infants after 200 μg i.m. (n = 4), 500 μg i.m. (n = 4), or 200 μg i.v. (n = 5). In preterm infants, we also measured serum K1, vitamin K1 2,3-epoxide, and PIVKA-II at 5 d postpartum. Before prophylaxis, the rate of 5C- and 7C-aglycone excretion was 25 times lower than adults, reflecting low vitamin K stores at birth. After prophylaxis, the excretion rate correlated to K1 dose (r = 0.6) but was two orders of magnitude lower than that in adults, probably reflecting the immaturity of neonatal catabolism. All term and 10 of 13 preterm infants mainly excreted 5C-aglycone. We present evidence that increased excretion of the 7C-aglycone was associated with metabolic overload because of the exposure to high-tissue K1 concentrations. Measurement of the 5C- and 7C-aglycones may facilitate longitudinal studies of vitamin K status in neonates and aid the development of improved prophylactic regimens. ABBREVIATIONS::
Dominic Jon Harrington; Paul Clarke; David J Card; Simon J Mitchell; Martin J Shearer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric research     Volume:  68     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-07-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-12     Citation Subset:  IM    
The Nutristasis Unit [D.J.H., D.J.C., M.J.S.], St. Thomas' Hospital, London SE1 7EH, United Kingdom; Norfolk and Norwich University Hospitals [P.C.], NHS Foundation Trust, Norwich NR4 7UY, United Kingdom; Newborn Intensive Care Unit [S.J.M.], St. Mary's Hospital, Manchester M13 9WL, United Kingdom.
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