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Interaction between vitamin K nutriture and bacterial overgrowth in hypochlorhydria induced by omeprazole.
- Source :
-
The American journal of clinical nutrition [Am J Clin Nutr] 1998 Sep; Vol. 68 (3), pp. 699-704. - Publication Year :
- 1998
-
Abstract
- Subjects taking a hydrogen pump blocking agent (omeprazole) develop bacterial overgrowth of the small intestine. We tested the hypothesis that this bacterial overgrowth produces menaquinones, which would meet the vitamin requirement in situations of vitamin K deficiency. In a crossover-type design, 13 healthy volunteers eating a phylloquinone-restricted diet for 35 d were randomly assigned to take omeprazole during the first period of study or starting on day 15 until the end of the study. Coagulation times, serum osteocalcin [total osteocalcin and undercarboxylated osteocalcin (ucOC)], plasma phylloquinone, urinary gamma-carboxyglutamic acid, and plasma undercarboxylated prothrombin (PIVKA-II) were measured. Plasma phylloquinone concentrations declined 82% with dietary phylloquinone restriction (P < 0.05) and were not significantly different in the period when the diet was combined with omeprazole treatment (P > 0.05). The mean value for PIVKA-II during the phylloquinone-restricted diet significantly increased 5.7-fold from baseline (P < 0.05); however, the combination of omeprazole treatment and the phylloquinone-restricted diet significantly reduced PIVKA-II values by 21% (P < 0.05) compared with the diet period alone. There were no alterations in total or percentage ucOC concentrations during the phylloquinone-restricted diet or during the period of diet plus omeprazole treatment. Our data support the hypothesis that bacterial overgrowth results in the synthesis and absorption of menaquinones. These menaquinones contribute to vitamin K nutriture during dietary phylloquinone restriction, but not enough to restore normal vitamin K status.
- Subjects :
- 1-Carboxyglutamic Acid urine
Achlorhydria chemically induced
Achlorhydria microbiology
Adult
Aged
Cross-Over Studies
Diet
Drug Interactions
Humans
Intestine, Small metabolism
Intestine, Small microbiology
Middle Aged
Omeprazole administration & dosage
Osteocalcin blood
Protein Precursors metabolism
Prothrombin metabolism
Vitamin K 1 administration & dosage
Vitamin K 1 blood
Vitamin K Deficiency metabolism
Achlorhydria metabolism
Bacteria growth & development
Biomarkers
Intestine, Small drug effects
Omeprazole pharmacology
Vitamin K biosynthesis
Vitamin K 1 pharmacology
Vitamin K Deficiency drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9165
- Volume :
- 68
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of clinical nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 9734750
- Full Text :
- https://doi.org/10.1093/ajcn/68.3.699