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Wasilewski GB, Vervloet MG, Schurgers LJ. The Bone-Vasculature Axis: Calcium Supplementation and the Role of Vitamin K. Front Cardiovasc Med 2019; 6:6. [PMID: 30805347 PMCID: PMC6370658 DOI: 10.3389/fcvm.2019.00006] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
Calcium supplements are broadly prescribed to treat osteoporosis either as monotherapy or together with vitamin D to enhance calcium absorption. It is still unclear whether calcium supplementation significantly contributes to the reduction of bone fragility and fracture risk. Data suggest that supplementing post-menopausal women with high doses of calcium has a detrimental impact on cardiovascular morbidity and mortality. Chronic kidney disease (CKD) patients are prone to vascular calcification in part due to impaired phosphate excretion. Calcium-based phosphate binders further increase risk of vascular calcification progression. In both bone and vascular tissue, vitamin K-dependent processes play an important role in calcium homeostasis and it is tempting to speculate that vitamin K supplementation might protect from the potentially untoward effects of calcium supplementation. This review provides an update on current literature on calcium supplementation among post-menopausal women and CKD patients and discusses underlying molecular mechanisms of vascular calcification. We propose therapeutic strategies with vitamin K2 treatment to prevent or hold progression of vascular calcification as a consequence of excessive calcium intake.
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Affiliation(s)
- Grzegorz B Wasilewski
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands.,Nattopharma ASA, Hovik, Norway
| | - Marc G Vervloet
- Department of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
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Villa JKD, Diaz MAN, Pizziolo VR, Martino HSD. Effect of vitamin K in bone metabolism and vascular calcification: A review of mechanisms of action and evidences. Crit Rev Food Sci Nutr 2018; 57:3959-3970. [PMID: 27437760 DOI: 10.1080/10408398.2016.1211616] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Osteoporosis is a public health concern associated with an increased risk of bone fractures and vascular calcification. Vitamin K presents unique benefits on these issues, although understudied. The two main forms of vitamin K are phylloquinone (vitamin K1) and menaquinone (vitamin K2). In this study, it was especially investigated the action of vitamin K2 in bones and vessels. Vitamin K2 has shown to stimulate bone formation by promoting osteoblast differentiation and carboxylation of osteocalcin, and increasing alkaline phosphatase, insulin-like growth factor-1, growth differentiation factor-15, and stanniocalcin 2 levels. Furthermore, vitamin K2 reduces the pro-apoptotic proteins Fas and Bax in osteoblasts, and decreases osteoclast differentiation by increasing osteoprotegerin and reducing the receptor activator of nuclear factor kappa-B ligand. In blood vessels, vitamin K2 reduces the formation of hydroxyapatite, through the carboxylation of matrix Gla protein and Gla rich protein, inhibits the apoptosis of vascular smooth muscle cells, by increasing growth arrest-specific gene 6, and reduces the transdifferentiation of vascular smooth muscle cells to osteoblasts. The commonly used dosage of vitamin K2 in human studies is 45 mg/day and its application can be an interesting strategy in benefitting bone and vascular health, especially to osteoporotic post-menopausal women.
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Affiliation(s)
- Julia Khéde Dourado Villa
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
| | - Marisa Alves Nogueira Diaz
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
| | - Virgínia Ramos Pizziolo
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
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Douthit MK, Fain ME, Nguyen JT, Williams CF, Jasti AH, Gutin B, Pollock NK. Phylloquinone Intake Is Associated with Cardiac Structure and Function in Adolescents. J Nutr 2017; 147:1960-1967. [PMID: 28794209 PMCID: PMC5610549 DOI: 10.3945/jn.117.253666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/12/2017] [Accepted: 07/07/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Associations between childhood vitamin K consumption and cardiac structure and function have not been investigated. OBJECTIVE We determined associations between phylloquinone (vitamin K-1) intake and left ventricular (LV) structure and function in adolescents. METHODS We assessed diet with three to seven 24-h recalls and physical activity (PA) by accelerometry in 766 adolescents (aged 14-18 y, 50% female, 49% black). Fat-free soft tissue (FFST) mass and fat mass were measured by dual-energy X-ray absorptiometry. LV structure [LV mass (g)/height (m)2.7 (LV mass index) and relative wall thickness] and function [midwall fractional shortening (MFS) and ejection fraction] were assessed by echocardiography. Associations were evaluated by comparing the LV structure and function variables across tertiles of phylloquinone intake. Prevalence and OR of LV hypertrophy (LV mass index >95th percentile for age and sex) were also assessed by phylloquinone tertiles. RESULTS The prevalence of LV hypertrophy progressively decreased across tertiles of phylloquinone intake (P-trend < 0.01). Multinomial logistic regression-adjusting for age, sex, race, Tanner stage, systolic blood pressure, FFST mass, fat mass, socioeconomic status, PA, and intakes of energy, fiber, calcium, vitamin C, vitamin D, and sodium-revealed that compared with the highest phylloquinone intake tertile (reference group), the adjusted OR for LV hypertrophy was 3.3 (95% CI: 1.2, 7.4) for those in the lowest phylloquinone intake tertile. When LV structure variables were compared across phylloquinone intake tertiles adjusting for the same covariates, there were significant linear downward trends for LV mass index (6.5% difference, tertile 1 compared with tertile 3) and relative wall thickness (9.2% difference, tertile 1 compared with tertile 3; both P-trend ≤ 0.02). Conversely, significant linear upward trends across phylloquinone intake tertiles were observed for MFS (3.4% difference, tertile 1 compared with tertile 3) and ejection fraction (2.6% difference, tertile 1 compared with tertile 3; both P-trend < 0.04). CONCLUSION Our adolescent data suggest that subclinical cardiac structure and function variables are most favorable at higher phylloquinone intakes.
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Affiliation(s)
- Mary K Douthit
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Mary Ellen Fain
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Joshua T Nguyen
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Celestine F Williams
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Allison H Jasti
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Bernard Gutin
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Norman K Pollock
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA
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4
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Tyśkiewicz K, Dębczak A, Gieysztor R, Szymczak T, Rój E. Determination of fat- and water-soluble vitamins by supercritical fluid chromatography: A review. J Sep Sci 2017; 41:336-350. [DOI: 10.1002/jssc.201700598] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Katarzyna Tyśkiewicz
- Supercritical Extraction Department; New Chemical Syntheses Institute; Puławy Poland
| | - Agnieszka Dębczak
- Supercritical Extraction Department; New Chemical Syntheses Institute; Puławy Poland
| | - Roman Gieysztor
- Supercritical Extraction Department; New Chemical Syntheses Institute; Puławy Poland
| | - Tomasz Szymczak
- Supercritical Extraction Department; New Chemical Syntheses Institute; Puławy Poland
| | - Edward Rój
- Supercritical Extraction Department; New Chemical Syntheses Institute; Puławy Poland
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Danziger J, Young RL, Shea MK, Tracy RP, Ix JH, Jenny NS, Mukamal KJ. Vitamin K-Dependent Protein Activity and Incident Ischemic Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol 2016; 36:1037-42. [PMID: 27034472 PMCID: PMC5844474 DOI: 10.1161/atvbaha.116.307273] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/14/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Vitamin K-dependent proteins (VKDPs), which require post-translational modification to achieve biological activity, seem to contribute to thrombus formation, vascular calcification, and vessel stiffness. Whether VKDP activity is prospectively associated with incident cardiovascular disease has not been studied. APPROACH AND RESULTS VKDP activity was determined by measuring circulating des-γ-carboxy prothrombin concentrations in a random sample of 709 multiethnic adults free of cardiovascular disease drawn from the Multi-Ethnic Study of Atherosclerosis (MESA). Lower des-γ-carboxy prothrombin concentrations reflect greater VKDP activity. Subjects were followed up for the risk of ischemic cardiovascular disease (coronary heart disease, stroke, and fatal cardiovascular disease) for 11.0 years of follow-up. A total of 75 first ischemic CVD events occurred during follow-up. The incidence of ischemic cardiovascular disease increased progressively across des-γ-carboxy prothrombin quartiles, with event rates of 5.9 and 11.7 per 1000 person-years in the lowest and highest quartiles. In analyses adjusted for traditional cardiovascular risk factors and measures of vitamin K intake, a doubling of des-γ-carboxy prothrombin concentration was associated with a 1.53 (95% confidence interval, 1.09-2.13; P=0.008) higher risk of incident ischemic cardiovascular disease. The association was consistent across strata of participants with diabetes mellitus, hypertension, renal impairment, and low vitamin K nutritional intake. CONCLUSIONS In this sample of middle-aged and older adults, VKDP activity was associated with incident ischemic cardiovascular events. Further studies to understand the role of this large class of proteins in cardiovascular disease are warranted.
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Affiliation(s)
- John Danziger
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.).
| | - Rebekah L Young
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
| | - M Kyla Shea
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
| | - Russell P Tracy
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
| | - Joachim H Ix
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
| | - Nancy S Jenny
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
| | - Kenneth J Mukamal
- From the Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.D., K.J.M.); Department of Biostatistics, University of Washington, Seattle (R.L.Y.); Human Nutrition Research Center on Aging, Tufts University, Boston, MA (K.M.S.); College of Medicine (R.P.T.) and Department of Pathology (N.S.J.), University of Vermont, Burlington; and Nephrology Section, Veterans Affairs San Diego Healthcare System, CA (J.H.I.)
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Caluwé R, Pyfferoen L, De Boeck K, De Vriese AS. The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcification: ongoing randomized controlled trials. Clin Kidney J 2015; 9:273-9. [PMID: 26985380 PMCID: PMC4792621 DOI: 10.1093/ckj/sfv146] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 11/30/2015] [Indexed: 01/02/2023] Open
Abstract
Background The extent and the progression of vascular calcification (VC) are independent predictors of cardiovascular risk in the haemodialysis population. Vitamin K is essential for the activation of matrix gla protein (MGP), a powerful inhibitor of tissue calcification. Functional vitamin K deficiency may contribute to the high VC burden in haemodialysis patients. In addition, haemodialysis patients are frequently treated with vitamin K antagonists, mainly to prevent stroke in atrial fibrillation, potentially compounding the cardiovascular risk in these already vulnerable patients. New oral anticoagulants (NOACs) are valuable alternatives to vitamin K antagonists in the general population, but their use in dialysis has been encumbered by substantial renal clearance. However, a recent pharmacokinetic study provided information on how to use rivaroxaban in haemodialysis patients. Methods We conduct a randomized, prospective, multicentre, open-label interventional clinical trial that will include 117 chronic haemodialysis patients with non-valvular atrial fibrillation, treated with or candidates for treatment with vitamin K antagonists. Patients will be randomized to a vitamin K antagonist titrated weekly to an international normalized ratio between 2 and 3, a daily dose of rivaroxaban of 10 mg, or a daily dose of rivaroxaban 10 mg with a thrice weekly supplement of 2000 µg vitamin K2. Cardiac computed tomography, pulse wave velocity (PWV) measurements and MGP sampling will be performed at baseline, 6 months, 12 months and 18 months. Primary endpoints include progression of coronary artery and thoracic aorta calcification and changes in PWV. Secondary endpoints are progression of aortic and mitral valve calcification, all-cause mortality, major adverse cardiovascular events, stroke and bleeding. The ClinicalTrials.gov database was searched to retrieve related trials. Results Seven trials, three of which are performed in the haemodialysis population, evaluate whether pharmacological doses of vitamin K1 or K2 retard progression of VC. Five studies compare the effect of warfarin and NOACs on progression of VC, the present study being the only conducted in the dialysis population. Conclusion Vitamin K deficiency may be a modifiable cardiovascular risk factor in the haemodialysis population. Conversely, vitamin K antagonists may aggravate VC burden in haemodialysis patients. Several ongoing trials may provide an answer to these questions in the near future.
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Affiliation(s)
| | - Lotte Pyfferoen
- Department of Medical Imaging , AZ Sint-Jan Brugge , Brugge , Belgium
| | - Koen De Boeck
- Division of Nephrology , ZNA Hospital , Antwerp , Belgium
| | - An S De Vriese
- Division of Nephrology and Infectious Diseases , AZ Sint-Jan Brugge , Brugge , Belgium
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7
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Delanaye P, Liabeuf S, Bouquegneau A, Cavalier É, Massy ZA. [The matrix-gla protein awakening may lead to the demise of vascular calcification]. Nephrol Ther 2015; 11:191-200. [PMID: 25794931 DOI: 10.1016/j.nephro.2014.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 12/12/2022]
Abstract
Matrix-gla-protein (MGP) is mainly secreted by chondrocytes and smooth vascular muscle cells. This potent inhibitor of vascular calcification need to undergo 2 post-transcriptional steps to be fully active: one phosphorylation of 3 serine residues (on 5) and a carboxylation of 5 glutamate residues (on 9). Like other "Gla" proteins, this carboxylation is vitamin K dependant. Several forms of MGP thus circulate in the plasma, some of them being totally inactive (the unphosphorylated and uncarboxylated MGP), some others being partially or fully active, according to the number of phosphorylated or carboxylated sites. A theoretical link exists between MGP, vitamin K, vascular calcifications and cardiovascular diseases. This link is even more evident in patients suffering from chronic kidney diseases (CKD), and notably hemodialysis patients. If this link has been demonstrated in different experimental studies, clinical studies are mainly observational and their results must be interpreted accordingly. MGP concentrations are definitely not yet a surrogate to estimate the levels of vascular calcification, but could allow the monitoring of vitamin K treatment. Modulation of MGP concentrations may reduce vascular calcification in hemodialyzed patients, if the large ongoing trials show an efficiency of this treatment. In this review, we will summarize the role of MGP in the vascular calcifications process, describe the problems linked to the analytical determination of MGP in plasma and finally describe the different clinical studies on MGP and vascular calcifications in the general population and in CKD patients.
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Affiliation(s)
- Pierre Delanaye
- Service de néphrologie-dialyse, université de Liège, CHU Sart Tilman, 4000 Liège, Belgique.
| | | | - Antoine Bouquegneau
- Service de néphrologie-dialyse, université de Liège, CHU Sart Tilman, 4000 Liège, Belgique
| | - Étienne Cavalier
- Service de chimie clinique, université de Liège, CHU Sart Tilman, 4000 Liège, Belgique
| | - Ziad A Massy
- Inserm U-1088, UPJV, Amiens, France; Service de néphrologie, hôpital Ambroise-Paré, UVSQ, Boulogne-Billancourt, France
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8
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Hendriks EJE, de Jong PA, van der Graaf Y, Mali WPTM, van der Schouw YT, Beulens JWJ. Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis 2014; 239:11-20. [PMID: 25568948 DOI: 10.1016/j.atherosclerosis.2014.12.035] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/08/2014] [Accepted: 12/16/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Breast arterial calcifications (BAC), regularly observed at mammography, are medial calcifications and as such an expression of arteriosclerosis. Our objective was to evaluate and summarize the available evidence on the associations of BAC with cardiovascular risk factors and cardiovascular risk. METHODS A systematic literature review and meta-analysis were conducted. Embase and PubMed databases were searched. After critical appraisal, odds ratios were extracted from studies of moderate or good quality that examined risk factors for BAC or associations of BAC with cardiovascular disease. Random effects model meta-analyses were used to calculate pooled odds ratios and 95% confidence intervals (95%CIs). RESULTS BAC prevalence is around 12.7% among women in breast cancer screening programs. Increasing age (pooled OR 2.98 [95%CI 2.31-3.85] for every 10 years), diabetes (pooled OR: 1.88 [95%CI 1.36-2.59]) and parity as opposed to nulliparity (pooled OR 3.43 [95%CI 2.23-5.27]) are associated with higher BAC prevalence. Smoking is associated with lower BAC prevalence (pooled OR 0.48 [95%CI 0.39-0.60]). No associations were found with hypertension, obesity or dyslipidemia. Although longitudinal studies (n = 3) were scarce, BAC appear to be associated with an increased risk of cardiovascular disease events (adjusted hazard ratios for coronary heart disease ranging from 1.32 [95%CI 1.08-1.60] to 1.44 [95%CI1.02-2.05]). CONCLUSION BAC appear to be associated with an increased risk of cardiovascular disease events, while only being associated with some of the known cardiovascular risk factors, illustrating that medial arterial calcification might contribute to cardiovascular disease through a pathway distinct from the intimal atherosclerotic process.
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Affiliation(s)
- Eva J E Hendriks
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem P Th M Mali
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joline W J Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Varsha MKNS, Thiagarajan R, Manikandan R, Dhanasekaran G. Vitamin K1 alleviates streptozotocin-induced type 1 diabetes by mitigating free radical stress, as well as inhibiting NF-κB activation and iNOS expression in rat pancreas. Nutrition 2014; 31:214-22. [PMID: 25466668 DOI: 10.1016/j.nut.2014.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/22/2014] [Accepted: 05/19/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to understand the mechanism of action of vitamin K1 against streptozotocin (STZ)-induced diabetes. METHODS Male Wistar rats were administered 35 mg/kg STZ and after 3 d were treated with vitamin K1 (5 mg/kg, twice a week) for 3 months. Blood glucose was monitored twice a month. At the end of the study, animals were sacrificed and pancreas dissected out and analyzed for free radicals, antioxidants, metabolic enzymes related to glucose, membrane ATPases, histopathological evaluation, and expression of nuclear factor (NF)-κB and inducible nitric oxide synthase (iNOS). Glycated hemoglobin, plasma insulin, and islet area were determined at the end of the study. RESULTS Treatment of STZ-induced type 1 diabetic rats with vitamin K1 reduced oxidative stress, enhanced antioxidants, and inhibited aldose reductase in pancreas. Vitamin K1 administration rescued endocrine pancreas from STZ-induced cell death, resulting in enhanced insulin secretion and normal blood glucose and glycosylated hemoglobin levels. Histologic analyses also showed the antidiabetic potential of vitamin K1. Measure of pancreatic islet area showed an increase in the islet area upon vitamin K1 treatment when compared with the STZ-administered group, suggesting the possibility of regeneration. To understand the mechanism involved in vitamin K1 mediated changes, we performed immunohistochemical analyses for NF-κB and iNOS enzyme. Vitamin K1 was shown to suppress NF-κB activation and iNOS expression in the islets upon administration of STZ. CONCLUSION This work shows, to our knowledge for the first time, the mechanism of action of vitamin K1 against type 1 diabetes and the possible therapeutic use of this vitamin in stimulating islet cell proliferation/regeneration.
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Affiliation(s)
- M K N Sai Varsha
- Department of Bioengineering, School of Chemical & Biotechnology, SASTRA University, Thanjavur, India
| | - R Thiagarajan
- Department of Bioengineering, School of Chemical & Biotechnology, SASTRA University, Thanjavur, India.
| | - R Manikandan
- Department of Zoology, University of Madras, Guindy Campus, Chennai, India
| | - G Dhanasekaran
- Department of Zoology, University of Madras, Guindy Campus, Chennai, India
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10
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Abstract
Recent reports have attributed the potential health benefits of vitamin K beyond its function to activate hepatic coagulation factors. Moreover, several studies have suggested that menaquinones, also known as vitamin K2, may be more effective in activating extra-hepatic vitamin K-dependent proteins than phylloquinone, also known as vitamin K1. Nevertheless, present dietary reference values (DRV) for vitamin K are exclusively based on phylloquinone, and its function in coagulation. The present review describes the current knowledge on menaquinones based on the following criteria for setting DRV: optimal dietary intake; nutrient amount required to prevent deficiency, maintain optimal body stores and/or prevent chronic disease; factors influencing requirements such as absorption, metabolism, age and sex. Dietary intake of menaquinones accounts for up to 25% of total vitamin K intake and contributes to the biological functions of vitamin K. However, menaquinones are different from phylloquinone with respect to their chemical structure and pharmacokinetics, which affects bioavailability, metabolism and perhaps impact on health outcomes. There are significant gaps in the current knowledge on menaquinones based on the criteria for setting DRV. Therefore, we conclude that further investigations are needed to establish how differences among the vitamin K forms may influence tissue specificities and their role in human health. However, there is merit for considering both menaquinones and phylloquinone when developing future recommendations for vitamin K intake.
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11
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Presse N, Gaudreau P, Greenwood CE, Kergoat MJ, Morais JA, Payette H, Shatenstein B, Ferland G. A single measurement of serum phylloquinone is an adequate indicator of long-term phylloquinone exposure in healthy older adults. J Nutr 2012; 142:1910-6. [PMID: 22915296 DOI: 10.3945/jn.112.164608] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Assessment of long-term phylloquinone exposure is challenging in studies investigating vitamin K in health. Data are equivocal as to whether a single measurement of circulating phylloquinone would be adequate. The primary purpose of the present study was to validate the use of a single measurement of serum phylloquinone as a surrogate for long-term phylloquinone exposure in healthy older adults. Using data from the Québec Longitudinal Study on Nutrition and Successful Aging, the objectives were to: 1) determine the reproducibility of circulating phylloquinone over 2 y (n = 234); 2) calculate how a single measurement would rank or classify individuals and attenuate the regression coefficient between circulating phylloquinone and a health outcome; and 3) investigate the association of a single measurement of serum phylloquinone with long-term phylloquinone intakes assessed over the year prior to the blood draw (n = 228). The variance analysis based on 2 blood samples showed a fair to good reproducibility for serum phylloquinone (intra-class correlation = 0.49). The correlation coefficient between the ranking of individuals based on a single measurement of circulating phylloquinone and the "true" ranking would be 0.70. The multiple regression analysis showed that long-term phylloquinone intake was the strongest predictor of serum phylloquinone (t = 4.94; P < 0.001). The partial correlation coefficient (r = 0.32) was comparable with those reported in studies where blood sampling and diet recording were juxtaposed and/or multiple blood samples were used. The present study provides evidence that the use of a single measurement of circulating phylloquinone is adequate for assessing long-term phylloquinone exposure in healthy older adults.
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Affiliation(s)
- Nancy Presse
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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Cranenburg ECM, Schurgers LJ, Uiterwijk HH, Beulens JWJ, Dalmeijer GW, Westerhuis R, Magdeleyns EJ, Herfs M, Vermeer C, Laverman GD. Vitamin K intake and status are low in hemodialysis patients. Kidney Int 2012; 82:605-10. [PMID: 22648294 DOI: 10.1038/ki.2012.191] [Citation(s) in RCA: 132] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vitamin K is essential for the activity of γ-carboxyglutamate (Gla)-proteins including matrix Gla28 protein and osteocalcin; an inhibitor of vascular calcification and a bone matrix protein, respectively. Insufficient vitamin K intake leads to the production of non-carboxylated, inactive proteins and this could contribute to the high risk of vascular calcification in hemodialysis patients. To help resolve this, we measured vitamin K(1) and K(2) intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140 μg/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K(1) and K(2) intake 200 μg/day and 31 μg/day, respectively). Non-carboxylated bone and coagulation proteins were found to be elevated in 33 hemodialysis patients, indicating subclinical hepatic vitamin K deficiency. Additionally, very high non-carboxylated matrix Gla28 protein levels, endemic to all patients, suggest vascular vitamin K deficiency. Thus, compared to healthy individuals, hemodialysis patients have a poor overall vitamin K status due to low intake. A randomized controlled trial is needed to test whether vitamin K supplementation reduces the risk of arterial calcification and mortality in hemodialysis patients.
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Affiliation(s)
- Ellen C M Cranenburg
- VitaK and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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13
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Scientific Opinion on the substantiation of a health claim related to vitamin K2 and contribution to the normal function of the heart and blood vessels (ID 125, further assessment) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J 2012. [DOI: 10.2903/j.efsa.2012.2714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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14
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Shea MK, Holden RM. Vitamin K status and vascular calcification: evidence from observational and clinical studies. Adv Nutr 2012; 3:158-65. [PMID: 22516723 PMCID: PMC3648716 DOI: 10.3945/an.111.001644] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Vascular calcification occurs when calcium accumulates in the intima (associated with atherosclerosis) and/or media layers of the vessel wall. Coronary artery calcification (CAC) reflects the calcium burden within the intima and media of the coronary arteries. In population-based studies, CAC independently predicts cardiovascular disease (CVD) and mortality. A preventive role for vitamin K in vascular calcification has been proposed based on its role in activating matrix Gla protein (MGP), a calcification inhibitor that is expressed in vascular tissue. Although animal and in vitro data support this role of vitamin K, overall data from human studies are inconsistent. The majority of population-based studies have relied on vitamin K intake to measure status. Phylloquinone is the primary dietary form of vitamin K and available supplementation trials, albeit limited, suggest phylloquinone supplementation is relevant to CAC. Yet observational studies have found higher dietary menaquinone, but not phylloquinone, to be associated with less calcification. Vascular calcification is highly prevalent in certain patient populations, especially in those with chronic kidney disease (CKD), and it is plausible vitamin K may contribute to reducing vascular calcification in patients at higher risk. Subclinical vitamin K deficiency has been reported in CKD patients, but studies linking vitamin K status to calcification outcomes in CKD are needed to clarify whether or not improving vitamin K status is associated with improved vascular health in CKD. This review summarizes the available evidence of vitamin K and vascular calcification in population-based studies and clinic-based studies, with a specific focus on CKD patients.
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Affiliation(s)
- M Kyla Shea
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem NC, USA.
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15
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Presse N, Payette H, Shatenstein B, Greenwood CE, Kergoat MJ, Ferland G. A minimum of six days of diet recording is needed to assess usual vitamin K intake among older adults. J Nutr 2011; 141:341-6. [PMID: 21178095 DOI: 10.3945/jn.110.132530] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
There is a growing interest in the role of vitamin K in health, especially in aging populations. Knowledge of inter- and intra-individual variability of dietary vitamin K intake could be useful to accurately assess usual intake and rank participants in epidemiological studies. Our objectives were to: 1) estimate the variance components of vitamin K intake; 2) investigate whether day of the week, season, and energy intake are factors related to intra-individual variance; and 3) calculate the requisite number of days to achieve desired degrees of accuracy for estimating individual vitamin K intake, ranking individuals and estimating regression coefficient. Vitamin K intake was assessed in 939 older adults (67-84 y) enrolled in the Québec Longitudinal Study on Nutrition and Successful Aging study using 2 sets of 3 nonconsecutive multiple-pass 24-h dietary recalls (24HR) collected 6 mo apart. Each set included 2 weekdays and one weekend day. Intra- to inter-individual variance ratios for vitamin K intake were 3.2 (95% CI = 2.6-3.9) overall, 2.6 (95% CI = 2.1-3.5) for men, and 3.7 (95% CI = 2.9-5.0) for women. Day of the week (weekdays) and season (May to October) were positively and significantly associated with vitamin K intake but explained a negligible part of intra-individual variation (<1%). Adjusting for energy intake explained <7% of variance and did not affect the variance ratio. Six to 13 24HR are required to properly rank individuals according to their usual vitamin K intake and limit attenuation of the regression coefficient. These results should be considered in studies planning to assess vitamin K intakes in older adults.
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Affiliation(s)
- Nancy Presse
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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16
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Scientific Opinion on the substantiation of health claims related to vitamin K and maintenance of bone (ID 123, 127, 128, and 2879), blood coagulation (ID 124 and 126), and function of the heart and blood vessels (ID 124, 125 and 2880) pursuant to Article. EFSA J 2009. [DOI: 10.2903/j.efsa.2009.1228] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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17
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Abstract
Recent interest in vitamin K has been motivated by evidence of physiological roles beyond that of coagulation. Vitamin K and vitamin K-dependent (VKD) proteins may be involved in regulation of calcification, energy metabolism, and inflammation. However, the evidence for many of these proposed roles in the maintenance of health is equivocal. There is also an emerging viewpoint that the biochemical function of vitamin K may extend beyond that of a cofactor for the VKD carboxylation of glutamyl residues (Glus) to carboxylated Glus in VKD proteins.
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Affiliation(s)
- Sarah L Booth
- Vitamin K Laboratory, Jean Mayer USDA Human Nutrition Research Center at Tufts University, Boston, MA 02111, USA.
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18
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Presse N, Shatenstein B, Kergoat MJ, Ferland G. Validation of a semi-quantitative food frequency questionnaire measuring dietary vitamin K intake in elderly people. ACTA ACUST UNITED AC 2009; 109:1251-5. [PMID: 19559145 DOI: 10.1016/j.jada.2009.04.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 12/02/2008] [Indexed: 01/07/2023]
Abstract
The study objective was to validate a semi-quantitative food frequency questionnaire (FFQ) specifically designed to measure dietary vitamin K intake. A 50-item FFQ was interviewer-administered and compared with data previously obtained from 5-day food records. Thirty-nine community-dwelling healthy men and women aged 65 to 85 years were recruited from the Montréal metropolitan area. Absolute and relative agreements between methods were assessed. Vitamin K intake measured by the vitamin K FFQ (mean+/-standard deviation; 222+/-186 microg/day) was significantly higher than that obtained by food records (135+/-153 microg/day; P<0.001). Bland-Altman analysis on log(10)-transformed data indicated that vitamin K intake from vitamin K FFQ was 2.26 times (95% confidence interval: 1.90 to 2.67) higher than food records, limits of agreement ranging from 0.80 to 6.35. However, correlation between methods was strong and highly significant (r=0.83; P<0.001). Cross-classification also showed that 72% of participants were correctly classified into thirds and only 8% were grossly miscategorized. Weighted kappa value (kappa=0.60) also indicated a good relative agreement. In light of these results, the vitamin K FFQ is a valid tool for ranking individuals according to their vitamin K intake. The poor absolute agreement likely results from the inability for food records to adequately measure the usual intake of episodically consumed foods, particularly those high in vitamin K. The vitamin K FFQ will be useful in large-scale, population-based research on vitamin K and disease as well as in clinical practice, especially that focusing on anticoagulant therapy.
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Affiliation(s)
- Nancy Presse
- Centre de recherche, Institut universitaire de gériatrie de Montréal and Département de nutrition, Université de Montréal, Montréal, Canada
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Abstract
PURPOSE OF REVIEW It has been hypothesized that insufficient intake of vitamin K may increase soft-tissue calcification owing to impaired gamma-carboxylation of the vitamin K-dependent protein matrix gamma-carboxyglutamic acid. The evidence to support this putative role of vitamin K intake in atherosclerosis is reviewed. RECENT FINDINGS In animal models, multiple forms of vitamin K have been shown to reverse the arterial calcification created by vitamin K antagonists. The human data, however, are less consistent. Phylloquinone, the primary dietary form, has not been associated consistently with the risk of cardiovascular diseases. High menaquinone intake may be associated with lower risk of coronary heart disease mortality, but this needs to be confirmed. SUMMARY The role of vitamin K in calcification remains controversial. Although biologically plausible, results from the human studies have not consistently supported this hypothesis.
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Affiliation(s)
- Arja T Erkkilä
- School of Public Health and Clinical Nutrition, University of Kuopio, Finland.
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