1. Combined low vitamin D and K status amplifies mortality risk
- Author
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Lyanne M. Kieneker, Ron T. Gansevoort, Martin H. de Borst, Joline W. J. Beulens, Adriana J. van Ballegooijen, Marc Vervloet, Leon J. Schurgers, Ido P. Kema, Stephan J. L. Bakker, Lifestyle Medicine (LM), Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Institute for Organ Transplantation (GIOT), Nephrology, ACS - Diabetes & metabolism, APH - Health Behaviors & Chronic Diseases, Epidemiology and Data Science, ACS - Heart failure & arrhythmias, Amsterdam Gastroenterology Endocrinology Metabolism, Internal medicine, Biochemie, and RS: Carim - B02 Vascular aspects thrombosis and Haemostasis
- Subjects
Adult ,Male ,medicine.medical_specialty ,D SUPPLEMENTATION ,Vitamin K ,Cardiovascular mortality ,JOINT ASSOCIATION ,Population ,Medicine (miscellaneous) ,PROTEIN ,030204 cardiovascular system & hematology ,METABOLISM ,Gastroenterology ,CALCIUM ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Matrix gla protein ,medicine ,Vitamin D and neurology ,Humans ,Prospective Studies ,030212 general & internal medicine ,Vitamin D ,Prospective cohort study ,education ,POPULATION ,Cause of death ,education.field_of_study ,Nutrition and Dietetics ,biology ,business.industry ,D-2 ,Calcium-Binding Proteins ,Hazard ratio ,Confounding ,Original Contribution ,Middle Aged ,All-cause mortality ,Confidence interval ,FRACTURE ,Cardiovascular Diseases ,DENSITY ,biology.protein ,Female ,Vitamin K Deficiency ,HEALTH ,business - Abstract
Objective To explore the association of both plasma vitamin D and K concentrations with all-cause mortality, cardiovascular mortality, and cardiovascular events in the general population. Methods We studied 4742 participants of the Prevention of REnal and Vascular ENd-Stage Disease (PREVEND) Study. At baseline, vitamin D and K status was determined by measurement of 25-hydroxyvitamin D [25(OH)D] and dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), respectively. Patients were categorized into: 25(OH)D 75 nmol/L and dp-ucMGP Results Mean age was 52.6 ± 11.9 years and 2513 (53%) were female. During a median of 14.2 year follow-up, 620 participants died of which 142 were due to cardiovascular causes. Combined low vitamin D and K status was present in 970 participants (20%) and was associated with a greater risk of all-cause mortality compared to high vitamin D and high vitamin K status group (n = 1424) after adjusting for potential confounders: hazard ratio 1.46 (95% confidence intervals 1.12–1.90). We observed similar trends, albeit non-significant for cardiovascular mortality, and cardiovascular events: 1.42 (0.79–2.55), 1.28 (0.93–1.77), respectively. Conclusions Combined low vitamin D and K status are associated with increased all-cause mortality risk and possibly with cardiovascular mortality and cardiovascular events compared with adequate vitamin D and K status. Future studies should investigate the effect of combined vitamin D and K supplementation on clinical outcomes.
- Published
- 2021