Vitamin K and Glucose-6-phosphate Dehydrogenase Deficiency: A Perspective

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ABSTRACT

The use of vitamin K in a patient with suspected or proven glucose-6-phosphate dehydrogenase (G6PD) deficiency is a controversial topic with divided opinions even among the subject experts. We thus aim to summarize the available literature and provide the personal viewpoint of the authors on this aspect.

How to cite this article

Pawaria A, Das MC, Sood V. Vitamin K and Glucose-6-phosphate Dehydrogenase Deficiency: A Perspective. Ann Pediatr Gastroenterol Hepatol 2023;5(3):47–51.

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Most cited references 52

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The role of menaquinones (vitamin K₂) in human health.

Cees Vermeer, R Schaik, J. W. J. Beulens … (2013)

Recent reports have attributed the potential health benefits of vitamin K beyond its function to activate hepatic coagulation factors. Moreover, several studies have suggested that menaquinones, also known as vitamin K2, may be more effective in activating extra-hepatic vitamin K-dependent proteins than phylloquinone, also known as vitamin K1. Nevertheless, present dietary reference values (DRV) for vitamin K are exclusively based on phylloquinone, and its function in coagulation. The present review describes the current knowledge on menaquinones based on the following criteria for setting DRV: optimal dietary intake; nutrient amount required to prevent deficiency, maintain optimal body stores and/or prevent chronic disease; factors influencing requirements such as absorption, metabolism, age and sex. Dietary intake of menaquinones accounts for up to 25% of total vitamin K intake and contributes to the biological functions of vitamin K. However, menaquinones are different from phylloquinone with respect to their chemical structure and pharmacokinetics, which affects bioavailability, metabolism and perhaps impact on health outcomes. There are significant gaps in the current knowledge on menaquinones based on the criteria for setting DRV. Therefore, we conclude that further investigations are needed to establish how differences among the vitamin K forms may influence tissue specificities and their role in human health. However, there is merit for considering both menaquinones and phylloquinone when developing future recommendations for vitamin K intake.

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Vitamin K-containing dietary supplements: comparison of synthetic vitamin K1 and natto-derived menaquinone-7.

Leon Schurgers, Kirsten J F Teunissen, Karly Hamulyák … (2007)

Vitamin K is a cofactor in the production of blood coagulation factors (in the liver), osteocalcin (in bone), and matrix Gla protein (cartilage and vessel wall). Accumulating evidence suggests that for optimal bone and vascular health, relatively high intakes of vitamin K are required. The synthetic short-chain vitamin K(1) is commonly used in food supplements, but recently the natural long-chain menaquinone-7 (MK-7) has also become available as an over-the-counter (OTC) supplement. The purpose of this paper was to compare in healthy volunteers the absorption and efficacy of K(1) and MK-7. Serum vitamin K species were used as a marker for absorption and osteocalcin carboxylation as a marker for activity. Both K(1) and MK-7 were absorbed well, with peak serum concentrations at 4 hours after intake. A major difference between the 2 vitamin K species is the very long half-life time of MK-7, resulting in much more stable serum levels, and accumulation of MK-7 to higher levels (7- to 8-fold) during prolonged intake. MK-7 induced more complete carboxylation of osteocalcin, and hematologists should be aware that preparations supplying 50 mug/d or more of MK-7 may interfere with oral anticoagulant treatment in a clinically relevant way.

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Menaquinones, bacteria, and the food supply: the relevance of dairy and fermented food products to vitamin K requirements.

Barbara Walther, J. Karl, Sarah Booth … (2013)

Vitamin K exists in the food supply as phylloquinone, a plant-based form and as menaquinones (MKs), a collection of isoprenologues mostly originating from bacterial synthesis. Although multiple bacterial species used as starter cultures for food fermentations synthesize MK, relatively little is known about the presence and distribution of MK in the food supply and the relative contribution of MK to total dietary vitamin K intake. Dairy products may be a predominant source of dietary MK in many regions of the world, and there is recent interest in enhancing the MK content of dairy products through identification and selection of MK-producing bacteria in dairy fermentations. This interest is increased by emerging evidence that current dietary recommendations based on the classic role of vitamin K as an enzyme cofactor for coagulation proteins may not be optimal for supporting vitamin K requirements in extrahepatic tissues and that MK may have unique bioactivity beyond that as an enzyme cofactor. Observational studies have reported favorable associations between MK intake and bone and cardiovascular health. Although randomized trials have provided some evidence to support the beneficial effects of MK on bone, the evidence to date is not definitive, and randomized trials have not yet examined MK intake in relation to cardiovascular outcomes. Food production practices provide a means to enhance dietary MK availability and intake. However, parallel research is needed to optimize these production practices, develop comprehensive food MK content databases, and test hypotheses of unique beneficial physiological roles of MK beyond that achieved by phylloquinone.

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Author and article information

Journal

Journal ID (publisher-id): APGH

Title: Annals of Pediatric Gastroenterology and Hepatology ISPGHAN

Abbreviated Title: APGH

Publisher: Jaypee Brothers Medical Publishers

ISSN (Electronic): 2583-5874

Publication date (Print): July-September 2023

Volume: 5

Issue: 3

Pages: 47-51

Affiliations

[1-2 ]Department of Pediatric Gastroenterology & Hepatology, Amrita School of Medicine, Faridabad, Haryana, India

[3 ]Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi, India

Author notes

Vikrant Sood, Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi, India, Phone: +91 9711143397, e-mail: drvickyster@ 123456gmail.com

Article

DOI: 10.5005/jp-journals-11009-0133

SO-VID: 5473c722-0b14-4ea7-a636-c9cdb9871f05

License:

© The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 13 June 2023

Date accepted : 21 July 2023

Date: 18 October 2023

Custom metadata

file-pdf apgh-05-047.pdf

ScienceOpen disciplines: Pediatrics

Keywords: Glucose-6-phosphate dehydrogenase deficiency,Review,Vitamin K

Data availability:

ScienceOpen disciplines: Pediatrics

Keywords: Glucose-6-phosphate dehydrogenase deficiency, Review, Vitamin K

Vitamin K and Glucose-6-phosphate Dehydrogenase Deficiency: A Perspective

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