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Abstract：
A low vitamin D and K status has been associated with increased cardiovascular disease (CVD) risk but the evidence of their combined effect on cardiovascular health is limited.
Our study aimed to investigate the prospective association of vitamin D and K status with subclinical measures of cardiovascular health and all-cause mortality among a population of Dutch Caucasians.
We performed an observational prospective study on 601 participants of the Hoorn Study (mean ± SD age: 70 ± 6 y, 50.4% women, BMI: 27.2 ± 4.0 kg/m2), of whom 321 underwent an echocardiogram in 2000-2001 and 2007-2009. Vitamin D and K status was assessed at baseline by serum 25-hydroxyvitamin D [25(OH)D] and plasma desphospho-uncarboxylated matrix-gla protein (dp-ucMGP)-high concentrations indicate low vitamin K status. Vital status was assessed from baseline until 2018. We studied the association of categories of 25(OH)D (stratified by the clinical cutoff of 50 mmol/L) and dp-ucMGP (stratified by the median value of 568 pmol/L) with echocardiographic measures using linear regression and with all-cause mortality using Cox regression, adjusted for confounders.
Compared with markers of normal vitamin D and K status, markers of low vitamin D and K status were prospectively associated with increased left ventricular mass index (5.9 g/m2.7; 95% CI: 1.8, 10.0 g/m2.7). Participants with low vitamin D and K status were also at increased risk of all-cause mortality with an HR of 1.64 (95% CI: 1.12, 2.39) compared with normal vitamin D and K status.
A combination of low vitamin D and K status is associated with adverse cardiac remodeling and increased risk of all-cause mortality in men and women. Future studies should investigate whether vitamin D and K supplementation could help to improve cardiovascular health and to decrease CVD risk.
Our study aimed to investigate the prospective association of vitamin D and K status with subclinical measures of cardiovascular health and all-cause mortality among a population of Dutch Caucasians.
We performed an observational prospective study on 601 participants of the Hoorn Study (mean ± SD age: 70 ± 6 y, 50.4% women, BMI: 27.2 ± 4.0 kg/m2), of whom 321 underwent an echocardiogram in 2000-2001 and 2007-2009. Vitamin D and K status was assessed at baseline by serum 25-hydroxyvitamin D [25(OH)D] and plasma desphospho-uncarboxylated matrix-gla protein (dp-ucMGP)-high concentrations indicate low vitamin K status. Vital status was assessed from baseline until 2018. We studied the association of categories of 25(OH)D (stratified by the clinical cutoff of 50 mmol/L) and dp-ucMGP (stratified by the median value of 568 pmol/L) with echocardiographic measures using linear regression and with all-cause mortality using Cox regression, adjusted for confounders.
Compared with markers of normal vitamin D and K status, markers of low vitamin D and K status were prospectively associated with increased left ventricular mass index (5.9 g/m2.7; 95% CI: 1.8, 10.0 g/m2.7). Participants with low vitamin D and K status were also at increased risk of all-cause mortality with an HR of 1.64 (95% CI: 1.12, 2.39) compared with normal vitamin D and K status.
A combination of low vitamin D and K status is associated with adverse cardiac remodeling and increased risk of all-cause mortality in men and women. Future studies should investigate whether vitamin D and K supplementation could help to improve cardiovascular health and to decrease CVD risk.
摘要：
低维生素D和K状态与心血管疾病（CVD）风险增加有关，但它们对心血管健康的综合影响的证据有限。
我们的研究旨在调查荷兰高加索人群中维生素D和K状态与心血管健康和全因死亡率亚临床指标的前瞻性关联。
我们对Hoorn研究的601名参与者进行了观察性前瞻性研究（平均±SD年龄：70±6岁，50.4%女性，BMI：27.2±4.0kg/m2），其中321人在2000-2001年和2007-2009年接受了超声心动图检查。通过血清25-羟基维生素D[25（OH）D]和血浆去磷酸-未羧化基质-gla蛋白（dp-ucMGP）在基线评估维生素D和K状态-高浓度表明维生素K状态低。从基线到2018年评估生命状况。我们研究了25（OH）D（通过50mmol/L的临床临界值进行分层）和dp-ucMGP（通过568pmol/L的中位值进行分层）的类别与使用线性回归的超声心动图测量值和使用Cox回归的全因死亡率的关联。针对混杂因素进行了调整。
与正常维生素D和K状态的标志物相比，低维生素D和K状态的标志物与左心室质量指数增加具有前瞻性相关性(5.9g/m2.7;95%CI:1.8,10.0g/m2.7).与正常的维生素D和K状态相比，维生素D和K状态低的参与者的全因死亡风险也增加，HR为1.64（95％CI：1.12，2.39）。
在男性和女性中，低维生素D和K状态的组合与不良心脏重塑和全因死亡风险增加相关。未来的研究应该调查补充维生素D和K是否有助于改善心血管健康和降低CVD风险。
我们的研究旨在调查荷兰高加索人群中维生素D和K状态与心血管健康和全因死亡率亚临床指标的前瞻性关联。
我们对Hoorn研究的601名参与者进行了观察性前瞻性研究（平均±SD年龄：70±6岁，
与正常维生素D和K状态的标志物相比，
在男性和女性中，低维生素D和K状态的组合与不良心脏重塑和全因死亡风险增加相关。
