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ARTICLE:
Steven P. Conway, Susan P. Wolfe, Keith G. Brownlee, Helen White, Brian Oldroyd, John G. Truscott, Julia M. Harvey, and Martin J. Shearer
Vitamin K Status Among Children With Cystic Fibrosis and Its Relationship to Bone Mineral Density and Bone Turnover
Pediatrics 2005; 115: 1325-1331 [Abstract] [Full text] [PDF]
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[Read P3R] Vitamin K or Vitamin E: more reason to screen newborns for cystic fibrosis
Dennis T Costakos, Mayo Clinic College of Medicine, Rochester, Minnesota, USA   (23 September 2005)

Vitamin K or Vitamin E: more reason to screen newborns for cystic fibrosis 23 September 2005
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Dennis T Costakos,
neonatologist
Mayo health System (Lacrosse Wisconsin )and,
Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Send letter to journal:
Re: Vitamin K or Vitamin E: more reason to screen newborns for cystic fibrosis

costakos.dennis{at}mayo.edu Dennis T Costakos, et al.

Can the authors comment on whether newborn screening for Cystic fibrosis is occurring in the United Kingdom, on if so, describe the screening process? Can the authors comment on timing of diagnosis and Vitamin K status? What about Vitamin K status and Cognitive development? Why do I ask? In the United states, some states screen newborns for Cystic fibrosis on the basis of a randomized, controlled trial showing nutitional and cognitive benefits for screened newborns (early diagnosis) compared to traditionally diagnosed children (average age 3 to 4 years of age).Good evidence for this includes the results of Koscik, RL et al. suugest that prevention of prolonged malnutrition by early diagnosis and nutritional therapy, particularly minimizing Vitamin e deficiency, is associated with better cognitive function.Vitamin E deficiency (alpha-tocopherol less than 300 micrograms/dl) at diagnosis has been implicated as one nutritional deficiency associated with subsequent lower cognitive stores. Vitamin K is present in the brain and has a role in the brain growth receptor system.The Body stores very little vitamin K. In fact, Vitamin k is rapidly depleted without regular dietary intake. Even the adult hepatic storage pool, measured by Shearer , is surprisingly small 1.7 to 38.3 micrograms (median 7.8 micrograms).In a child with cystic fibrosis, it is conceivable that Vitamin K deficiency not only would accompany other deficiencies of nutrition, but might be one of the first deficiencies to occur? In summary,I commend the authors for this important work. Vitamin K has been associated with bone health, and cystic fibrosis with stunted growth. I believe the Leeds group provides more data to support the screening of newborns for cystic fibrosis.

References: 1. Koscik RL, Farrell PM, Kosorok MR, Zaremba,KM, Laxova A, Lai,H-C, Douglas,JA, Rock MJ, Splaingard,ML. Cognitive function of children with cystic fibrosis: deleterious effect of early malnutrition.Pediatrics. 2004 Jun;113(6):1549-58. 2. Davidson RT, Foley AL, Engelke JA, Suttie JW. Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria. Nutrient Metabolism-Research Communication. Manuscript October 27, 1997:220-223. 3.Tsaioun KI. Vitamin K-dependent proteins in the developing and aging nervous system. Nutr Rev. 1999;57 :231 –240[ISI][Medline] 4.Ferland G. The vitamin K-dependent proteins: an update. Nutr Rev. 1998;56 :223 –230[ISI][Medline] 5.Li J, Lin JC, Wang H, et al. Novel role of vitamin K in preventing oxidative injury to developing oligodendrocytes and neurons. J Neurosci. 2003;23 :5816 –5826[Abstract/Free Full Text] 6. Carrie I, Portoukalian J, Vicaretti R et al Menaquinone-4concentration is correlated with sphingolipid concentrations in rat brain. J Nutr. 2004 Jan;134(1): 167-72 7.Costakos DT, Greer FR, Love LA, Dahlen LR, Sutte JW. Vitamin K prophylaxis for premature infants: 1 mg versus 0.5 mg. Am J Perinatol. 2003;20 :485 –490[ISI][Medline]

Conflict of Interest:

None declared