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Vitamin K Status in Women of Childbearing Years Before or After Bariatric Surgery

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Vitamin K Status in Women of Childbearing Years Before or After Bariatric Surgery

Linda M Bartholomay et al. Curr Dev Nutr.

Abstract

Background: Vitamin K adequacy has not been widely studied before or after bariatric surgery. Reports of babies born with intracranial bleeds to women after bariatric surgery make this an important vitamin to study in women of childbearing years.

Objectives: The aim of this study was to assess the functional vitamin K status in 2 groups of women of childbearing age, 1 group seeking bariatric surgery and 1 group post Roux-en-Y gastric bypass (RYGB).

Methods: In a cross-sectional design, 40 women [19 presurgical and 21 post-RYGB (6-18 mo following surgery)], aged 18-40 y, completed the study. Participants provided a 3-d food intake record and a list of dietary supplements routinely taken. Participants then underwent a commercially available test to measure des-γ-carboxyprothrombin (DCP) concentration as a measure of functional vitamin K status.

Results: Independent-samples t tests (P < 0.05) indicated that there was no significant difference [Sig (2-tailed) 0.821] between the DCP concentrations of the presurgical group and those of the post-RYGB group (mean ± SD DCP: 0.3 ± 0.1 and 0.4 ± 0.2 ng/mL, respectively). Vitamin K intake from food (248 ± 227 and 210 ± 239 μg) and supplements (13 ± 31 and 750 ± 271 μg) showed no linear correlation to DCP (presurgical group: 0.25 and -0.15, respectively; post-RYGB group: 0.13 and 0.05, respectively). Vitamin K intakes for both groups were above the current Institute of Medicine's recommended 90 μg/d for women. Bivariate correlation was conducted on other independent variables with only current BMI for the post-RYGB group having a moderate negative correlation to DCP (-0.54, P < 0.05). No correlation with statistical significance was found between other variables and DCP.

Conclusions: Although the American Society for Metabolic and Bariatric Surgery recommends DCP as a test to determine vitamin K adequacy, no published studies in pre- or post-RYGB patients have been performed with the current commercially available test, which is not FDA approved as a vitamin K biomarker. Previous studies reporting vitamin K inadequacies based on DCP utilized a different assay than the one currently available. Due to the importance of ensuring adequate maternal concentrations of vitamin K after bariatric surgery in order to prevent intracranial bleeding in babies, more research is needed to determine suitable vitamin K measures.

Keywords: Roux-en-Y; bariatric; bone health; des-γ-carboxyprothrombin; intracranial hemorrhage; osteoporosis; vitamin K; vitamin K deficiency; vitamin deficiencies; weight-loss surgery.

Figures

FIGURE 1
FIGURE 1
Flow diagram showing the number of presurgical and post-RYGB participants recruited (n = 60), excluded (n = 12), consented (n = 48), and the number people who completed the study (n = 19 presurgery; n = 21 postsurgery). DCP, des-γ-carboxyprothrombin; RYGB, Roux-en-Y gastric bypass.
FIGURE 2
FIGURE 2
Box plot of DCP concentration results for presurgery participants (No) and post-RYGB participants (Yes). Both groups had results in the normal range (<2.0 ng/mL). *Two values were not included in the analysis as a specific DCP concentration could not be determined below the generalized <1.0 mg/dL value. DCP, des-γ-carboxyprothrombin.

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