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Abstract：
OBJECTIVE: Vitamin K plays a pivotal role in the synthesis of Matrix Gla protein (MGP), a calcification inhibitor in vascular tissue. Vascular calcification has become an important predictor of cardiovascular disease. The aim of the current study was to examine the potential association of circulating desphospho-carboxylated and -uncarboxylated MGP (dp-cMGP and dp-ucMGP), reflecting vitamin K status, with the incidence of cardiovascular events and disease (CVD) in older individuals.
METHODS: The study was conducted in 577 community-dwelling older men and women of the Longitudinal Aging Study Amsterdam (LASA), aged >55 year, who were free of cardiovascular disease at baseline. Multivariate Cox proportional hazards models were used to analyze the data.
METHODS: Incidence of CVD.
RESULTS: After a mean follow-up of 5.6±1.2 year, we identified 40 incident cases of CVD. After adjustment for classical confounders and vitamin D status, we observed a more than 2-fold significantly higher risk of CVD for the highest tertile of dp-ucMGP with a HR of 2.69 (95% CI, 1.09-6.62) as compared with the lowest tertile. Plasma dp-cMGP was not associated with the risk of CVD.
CONCLUSIONS: Vitamin K insufficiency, as assessed by high plasma dp-ucMGP concentrations is associated with an increased risk for cardiovascular disease independent of classical risk factors and vitamin D status. Larger epidemiological studies on dp-ucMGP and CVD incidence are needed followed by clinical trials to test whether vitamin K-rich diets will lead to a decreased risk for cardiovascular events.
METHODS: The study was conducted in 577 community-dwelling older men and women of the Longitudinal Aging Study Amsterdam (LASA), aged >55 year, who were free of cardiovascular disease at baseline. Multivariate Cox proportional hazards models were used to analyze the data.
METHODS: Incidence of CVD.
RESULTS: After a mean follow-up of 5.6±1.2 year, we identified 40 incident cases of CVD. After adjustment for classical confounders and vitamin D status, we observed a more than 2-fold significantly higher risk of CVD for the highest tertile of dp-ucMGP with a HR of 2.69 (95% CI, 1.09-6.62) as compared with the lowest tertile. Plasma dp-cMGP was not associated with the risk of CVD.
CONCLUSIONS: Vitamin K insufficiency, as assessed by high plasma dp-ucMGP concentrations is associated with an increased risk for cardiovascular disease independent of classical risk factors and vitamin D status. Larger epidemiological studies on dp-ucMGP and CVD incidence are needed followed by clinical trials to test whether vitamin K-rich diets will lead to a decreased risk for cardiovascular events.
摘要：
目的：维生素K在基质Gla蛋白（MGP）的合成中起关键作用，血管组织中的钙化抑制剂。血管钙化已成为心血管疾病的重要预测因子。本研究的目的是检查循环去磷酸羧化和非羧化MGP（dp-cMGP和dp-ucMGP）的潜在关联，反映维生素K的状态，老年人心血管事件和疾病（CVD）的发生率。
方法：该研究是在阿姆斯特丹纵向衰老研究（LASA）的577名社区居住的老年男性和女性中进行的，年龄>55岁，基线时没有心血管疾病的患者.采用多因素Cox比例风险模型对数据进行分析。
方法：CVD的发生率。
结果：平均随访5.6±1.2年后，我们确定了40例CVD的事件。在调整经典混杂因素和维生素D状态后，我们观察到dp-ucMGP最高三分位数的CVD风险比最低三分位数的高2倍以上,HR为2.69(95%CI,1.09~6.62).血浆dp-cMGP与CVD风险无关。
结论：维生素K不足，根据血浆高dp-ucMGP浓度评估,与传统危险因素和维生素D状态无关,与心血管疾病风险增加相关.需要对dp-ucMGP和CVD发病率进行更大规模的流行病学研究，然后进行临床试验，以测试富含维生素K的饮食是否会降低心血管事件的风险。
方法：该研究是在阿姆斯特丹纵向衰老研究（LASA）的577名社区居住的老年男性和女性中进行的，年龄>55岁，基线时没有心血管疾病的患者.采用多因素Cox比例风险模型对数据进行分析。
方法：CVD的发生率。
结果：平均随访5.6±1.2年后，我们确定了40例CVD的事件。在调整经典混杂因素和维生素D状态后，我们观察到dp-ucMGP最高三分位数的CVD风险比最低三分位数的高2倍以上,HR为2.69(95%CI,1.09~6.62).血浆dp-cMGP与CVD风险无关。
结论：维生素K不足，根据血浆高dp-ucMGP浓度评估,与传统危险因素和维生素D状态无关,与心血管疾病风险增加相关.需要对dp-ucMGP和CVD发病率进行更大规模的流行病学研究，然后进行临床试验，以测试富含维生素K的饮食是否会降低心血管事件的风险。
