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Maturitas. 2014 Feb;77(2):137-41. doi: 10.1016/j.maturitas.2013.10.008. Epub 2013 Oct 24.

Circulating uncarboxylated matrix Gla protein, a marker of vitamin K status, as a risk factor of cardiovascular disease.

Author information

1
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Royal FrieslandCampina, Amersfoort, The Netherlands. Electronic address: ellen.vandenheuvel@frieslandcampina.com.
2
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: Nm.vanschoor@vumc.nl.
3
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Department of Internal Medicine and Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: P.lips@vumc.nl.
4
VitaK and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands. Electronic address: e.magdeleyns@vitak.com.
5
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: djh.deeg@vumc.nl.
6
VitaK and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands. Electronic address: c.vermeer@vitak.com.
7
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Department of Internal Medicine and Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: M.denHeijer@vumc.nl.

Abstract

OBJECTIVES:

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.

STUDY DESIGN:

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.

MAIN OUTCOME MEASURES:

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.

KEYWORDS:

CVD; Cardiovascular disease; Gla; LASA; Longitudinal Aging Study Amsterdam; MGP; Matrix Gla-protein; Vitamin K status; cardiovascular events and disease; desphospho-carboxylated MGP; desphospho-uncarboxylated MGP; dp-cMGP; dp-ucMGP; matrix Gla protein; γ-carboxyglutamate

PMID:
24210635
DOI:
10.1016/j.maturitas.2013.10.008
[Indexed for MEDLINE]

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