Me. Camilo et al., BIOAVAILABILITY OF PHYLLOQUINONE FROM AN INTRAVENOUS LIPID EMULSION, The American journal of clinical nutrition, 67(4), 1998, pp. 716-721
This randomized, controlled study evaluated the bioavailability of phy
lloquinone from an intravenous lipid emulsion. A mild vitamin K defici
ency was induced in 12 healthy adult men and women by dietary restrict
ion of phylloquinone (40 mu g/d, days 1-11) and by administration of w
arfarin (1.0 mg/d, days 5-11). On day 11, subjects received a 500-mL i
ntravenous solution of either lipid or saline, both of which contained
154 mu g phylloquinone. Bioavailability was assessed by serial measur
ements of plasma phylloquinone, vitamin K-1-2,3-epoxide, PIVKA-II (pro
teins induced by vitamin K absence or antagonists-II), and percentage
undercarboxylated osteocalcin. As a result of vitamin K deficiency and
minidose warfarin, vitamin K-1-2,3-epoxide, PIVKA-II, and percentage
undercarboxylated osteocalcin increased significantly between days 1 a
nd 11 (P = 0.05, 0.016, and 0.001, respectively). With the infusions,
plasma phyloquinone increased in both groups (P = 0.001). After the in
fusions vitamin K-1-2,3-epoxide decreased in both groups (P = 0.002).
Changes in plasma phylloquinone and vitamin K-1-2,3-epoxide were no di
fferent in the two groups (mean areas under the curves +/- SEM: 116 +/
- 13 nmol.NL for the saline group and 102 +/- 20 nmol.h/L for the lipi
d group for phylloquinone; 38.6 +/- 7.5 nmol.h/L for the saline group
and 31.3 +/- 9.0 nmol.h/L for the lipid group for vitamin K-1-2,3-epox
ide). PIVKA-II decreased significantly from baseline values (P = 0.005
) in both groups after the infusions. intravenous lipid reversed the e
ffects of minidose warfarin and of dietary restriction of phylloquinon
e on hemostasis and vitamin K nutritional status. This reversal was no
different from that seen with the infusion of phylloquinone in a sali
ne solution.