{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:19:45Z","timestamp":1788239985344,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with cystic fibrosis (CF) are at increased risk of fat\u2010soluble vitamin (A, D, E, and K) deficiencies secondary to exocrine pancreatic insufficiency (EPI). Estimation of vitamin K deficiency in routine clinical practice is challenging, and no uniform consensus exists due to lack of an accurate clinical test for the evaluation of its status. We aimed to estimate vitamin K status in people with CF using des\u2010gamma\u2010carboxy\u2010prothrombin (DCP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A single\u2010center retrospective chart review was done between 2022 and 2024. Ninety\u2010four (39 pediatric and 55 adult) people with CF were included for final review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median DCP value was 0.35\u2009ng\/mL (IQR 0.2\u20130.60; range was 0.1\u201311\u2009ng\/mL). Post hoc, we classified patients into low\u2010DCP (0\u201390th percentile values in DCP or \u2264\u20092\u2009ng\/mL) and high\u2010DCP (91\u2013100th percentile in DCP or &gt;2\u2009ng\/mL) groups. Eleven out of 94 (11.7%) patients had DCP\u2009&gt;\u20092\u2009ng\/mL; three out of 11 (27%) had advanced CF liver disease (aCFLD),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011, and another three had other fat\u2010soluble vitamin deficiencies, and low adherence to pancreatic enzymes and\/or vitamin supplementation was suspected,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011. There were no significant differences in demographics (age, gender) or other comorbidities between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DCP can be used for estimating vitamin K status, and the prevalence of suboptimal vitamin K status was 11.7%. DCP levels were higher in aCFLD, as well as those with suspected low adherence to pancreatic enzymes and\/or vitamin supplementation. Prospective, multicenter clinical trials are needed to evaluate this further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71777","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:00:42Z","timestamp":1786518042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utilization of Des\u2010Gamma\u2010Carboxy\u2010Prothrombin in Estimating Vitamin K Status in People With Cystic Fibrosis: A Single Center Retrospective Review"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-9703","authenticated-orcid":false,"given":"Senthilkumar","family":"Sankararaman","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology Cleveland Clinic Children's Hospital Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri","family":"Schindler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, UH Rainbow Babies and Children's Hospital Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4966-5113","authenticated-orcid":false,"given":"Aravind","family":"Thavamani","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, UH Rainbow Babies and Children's Hospital Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6983-9545","authenticated-orcid":false,"given":"Catherine","family":"Pamer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology UH Rainbow Babies and Children's Hospital Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison Marie","family":"Rodatt","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology UH Rainbow Babies and Children's Hospital Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9642-3814","authenticated-orcid":false,"given":"Kimberly A.","family":"McBennett","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, UH Rainbow Babies and Children's Hospital Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Roesch","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, UH Rainbow Babies and Children's Hospital Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-3793","authenticated-orcid":false,"given":"Alex H.","family":"Gifford","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, UH Cleveland Medical Center Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.03.004"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-nutr-080508-141217"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8010008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2013-201787"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-1993(03)00025-0"},{"key":"e_1_2_11_7_1","first-page":"73","article-title":"Nutrition Guidelines for Cystic Fibrosis in Australia and New Zealand","author":"Saxby N.","year":"2017","journal-title":"Thoracic Society of Australia and New Zealand"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.09.001"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000646"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2016.08.004"},{"issue":"44","key":"e_1_2_11_11_1","first-page":"48","article-title":"Vitamin K in Cystic Fibrosis","volume":"97","author":"Conway S. 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