scholarly journals Vitamin K2—a neglected player in cardiovascular health: a narrative review

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001715
Author(s):  
Essa Hariri ◽  
Nicholas Kassis ◽  
Jean-Pierre Iskandar ◽  
Leon J Schurgers ◽  
Anas Saad ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Vitamin K ◽  
Cardiovascular Health ◽  
Vitamin K2 ◽  
Cardiovascular Outcomes ◽  
Matrix Gla Protein ◽  
Direct Effects ◽  
Valvular Calcification ◽  
Inactive Form ◽  
The Subject

Vitamin K2 serves an important role in cardiovascular health through regulation of calcium homeostasis. Its effects on the cardiovascular system are mediated through activation of the anti-calcific protein known as matrix Gla protein. In its inactive form, this protein is associated with various markers of cardiovascular disease including increased arterial stiffness, vascular and valvular calcification, insulin resistance and heart failure indices which ultimately increase cardiovascular mortality. Supplementation of vitamin K2 has been strongly associated with improved cardiovascular outcomes through its modification of systemic calcification and arterial stiffness. Although its direct effects on delaying the progression of vascular and valvular calcification is currently the subject of multiple randomised clinical trials, prior reports suggest potential improved survival among cardiac patients with vitamin K2 supplementation. Strengthened by its affordability and Food and Drug Adminstration (FDA)-proven safety, vitamin K2 supplementation is a viable and promising option to improve cardiovascular outcomes.

scholarly journals Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Gerry Kurt Schwalfenberg
Keyword(s):  
Vascular Calcification ◽  
Vitamin K ◽  
Warfarin Therapy ◽  
Cardiovascular Health ◽  
Coronary Calcification ◽  
Renal Calculi ◽  
Bisphosphonate Therapy ◽  
Vitamin K2 ◽  
Level I ◽  
Clinical Conditions

Objective. To review the evidence for the use of vitamin K supplementation in clinical conditions such as osteoporosis, vascular calcification, arthritis, cancer, renal calculi, diabetes, and warfarin therapy.Quality of Evidence. PubMed was searched for articles on vitamin K (K1 and K2) along with books and conference proceedings and health conditions listed above. Level I and II evidence supports the use of vitamins K1 and K2 in osteoporosis and Level II evidence supports vitamin K2 in prevention of coronary calcification and cardiovascular disease. Evidence is insufficient for use in diabetes, arthritis, renal calculi, and cancer.Main Message.Vitamin K2 may be a useful adjunct for the treatment of osteoporosis, along with vitamin D and calcium, rivaling bisphosphonate therapy without toxicity. It may also significantly reduce morbidity and mortality in cardiovascular health by reducing vascular calcification. Vitamin K2 appears promising in the areas of diabetes, cancer, and osteoarthritis. Vitamin K use in warfarin therapy is safe and may improve INR control, although a dosage adjustment is required.Conclusion. Vitamin K supplementation may be useful for a number of chronic conditions that are afflicting North Americans as the population ages. Supplementation may be required for bone and cardiovascular health.

P66 VITAMIN K2 SUPPLEMENTATION REDUCES THE ELEVATED INACTIVE FORM OF THE CALCIFICATION INHIBITOR MATRIX Gla PROTEIN IN HEMODIALYSIS PATIENTS

2010 ◽  
Vol 11 (2) ◽  
pp. 30
Author(s):  
T. Krueger ◽  
R. Westenfeld ◽  
G. Schlieper ◽  
E. Cranenburg ◽  
S. Heidenreich ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Vitamin K2 ◽  
Matrix Gla Protein ◽  
Inactive Form

scholarly journals Role of Vitamin K in CKD: Is Its Supplementation Advisable in CKD Patients?

2021 ◽  
pp. 1-8
Author(s):  
Patrycja Grzejszczak ◽  
Ilona Kurnatowska
Keyword(s):  
Vitamin K ◽  
Disease Risk ◽  
Active Form ◽  
Serum Markers ◽  
Vitamin K2 ◽  
Matrix Gla Protein ◽  
Arterial Calcification ◽  
Increased Risk ◽  
Wall Calcification ◽  
Bone Complications

<b><i>Background:</i></b> Patients with CKD are at an increased risk of developing vascular calcification (VC) and bone complications which translate into a higher morbidity and mortality. The dephosphorylated and uncarboxylated matrix Gla protein (dp-ucMGP) is considered to be an indicator of vitamin K2 status and correlates with markers of VC. It is activated by γ-glutamyl carboxylase that converts inactive MGP into an active form, and vitamin K2 is a cofactor of this reaction. The active form of MGP is a known inhibitor of arterial wall calcification and plays an important role in bone turnover. Recent studies show poor vitamin K2 status in CKD patients. We aimed to review the literature for the association between vitamin K2 status and calcification and bone disease risk and the efficacy of vitamin K2 supplementation in CKD population. <b><i>Summary:</i></b> Most CKD patients, including those on renal replacement therapy, have vitamin K2 deficiency. The dp-ucMGP level, a marker of vitamin K2 status, is decreased by vitamin K2 supplementation in CKD patients, but there is no unequivocal proof that it influences arterial calcification progression and bone complications. <b><i>Key Messages:</i></b> CKD population are at risk of vitamin K deficiency. Supplementation of vitamin K2 is safe and improves the serum markers of its deficiency. There is lack of strong evidence that vitamin K2 supplementation slows progression of calcification or reduces the frequency of bone complications. More prospective studies are needed.

scholarly journals The Association of Vitamin D and Vitamin K Status with Subclinical Measures of Cardiovascular Health and All-Cause Mortality in Older Adults: The Hoorn Study

2020 ◽  
Vol 150 (12) ◽  
pp. 3171-3179
Author(s):  
Elisa Dal Canto ◽  
Joline W J Beulens ◽  
Petra Elders ◽  
Femke Rutters ◽  
Coen D A Stehouwer ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin K ◽  
Cardiovascular Health ◽  
Cox Regression ◽  
Left Ventricular ◽  
Matrix Gla Protein ◽  
Cvd Risk ◽  
Increased Risk ◽  
Normal Vitamin ◽  
All Cause Mortality

ABSTRACT Background 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. Objectives 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. Methods 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. Results 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. Conclusions 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.

scholarly journals Vitamin K status, supplementation and vascular disease: a systematic review and meta-analysis

Heart ◽  
2018 ◽  
pp. heartjnl-2018-313955 ◽  
Author(s):  
Jennifer Susan Lees ◽  
Fiona A Chapman ◽  
Miles D Witham ◽  
Alan G Jardine ◽  
Patrick B Mark
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Longitudinal Studies ◽  
Vitamin K ◽  
Cardiovascular Health ◽  
Meta Analysis ◽  
Matrix Gla Protein ◽  
Registration Number ◽  
Meta Analyses

ObjectivesVascular stiffness (VS) and vascular calcification (VC) are surrogate markers of vascular health associated with cardiovascular events. Vitamin K-dependent proteins (VKDP) are associated with VS and VC and require vitamin K for activity. We conducted a systematic review and meta-analysis of: (1) the effect of vitamin K supplementation on VS and VC and (2) association of inactive VKDP levels with incident cardiovascular disease and mortality.MethodsTwo authors searched MEDLINE and Embase databases and Cochrane and ISRCTN registries for studies of vitamin K clinical trials that measured effects on VC, VS or VKDP and longitudinal studies assessing effect of VKDP on incident CVD or mortality. Random effects meta-analyses were performed.ResultsThirteen controlled clinical trials (n=2162) and 14 longitudinal studies (n=10 726) met prespecified inclusion criteria. Vitamin K supplementation was associated with significant reduction in VC (−9.1% (95% CI −17.7 to −0.5); p=0.04) and VKDP (desphospho-uncarboxylated matrix Gla protein; −44.7% (95% CI −65.1 to −24.3), p<0.0001) and uncarboxylated osteocalcin; −12.0% (95% CI −16.7 to −7.2), p<0.0001) compared with control, with a non-significant improvement in VS. In longitudinal studies with median follow-up of 7.8 (IQR 4.9–11.3) years, VKDP levels were associated with a combined endpoint of CVD or mortality (HR 0.45 (95% CI 0.07 to 0.83), p=0.02).ConclusionsSupplementation with vitamin K significantly reduced VC, but not VS, compared with control. The conclusions drawn are limited by small numbers of studies with substantial heterogeneity. VKDP was associated with combined endpoint of CVD or mortality. Larger clinical trials of effect of vitamin K supplementation to improve VC, VS and long-term cardiovascular health are warranted.Trial registration numberCRD42017060344.

scholarly journals MK-7 and Its Effects on Bone Quality and Strength

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 965 ◽  
Author(s):  
Toshiro Sato ◽  
Naoko Inaba ◽  
Takatoshi Yamashita
Keyword(s):  
Bone Mineral Density ◽  
Bone Quality ◽  
Vitamin K ◽  
Half Life ◽  
Daily Intake ◽  
Vitamin K2 ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
Mineral Density ◽  
The Matrix

Vitamin K acts as a cofactor and is required for post-translational γ-carboxylation of vitamin K-dependent proteins (VKDP). The current recommended daily intake (RDI) of vitamin K in most countries has been established based on normal coagulation requirements. Vitamin K1 and menaquinone (MK)-4 has been shown to decrease osteocalcin (OC) γ-carboxylation at RDI levels. Among the several vitamin K homologs, only MK-7 (vitamin K2) can promote γ-carboxylation of extrahepatic VKDPs, OC, and the matrix Gla protein at a nutritional dose around RDI. MK-7 has higher efficacy due to its higher bioavailability and longer half-life than other vitamin K homologs. As vitamin K1, MK-4, and MK-7 have distinct bioactivities, their RDIs should be established based on their relative activities. MK-7 increases bone mineral density and promotes bone quality and strength. Collagen production, and thus, bone quality may be affected by MK-7 or MK-4 converted from MK-7. In this review, we comprehensively discuss the various properties of MK-7.

scholarly journals Knowledge and Awareness of Vitamin K Therapy among Dental Students

2020 ◽  
pp. 38-47
Author(s):  
Hena Mariam Fathima ◽  
Dhanraj Ganapathy ◽  
R. Subhashree ◽  
V. Rakshagan
Keyword(s):  
Vitamin K ◽  
Coagulation Factors ◽  
Study Data ◽  
Dental Students ◽  
Vitamin K2 ◽  
The Body ◽  
Matrix Gla Protein ◽  
Multiple Choice Questions ◽  
Cross Sectional ◽  
Level Of Knowledge

Vitamin K is a fat-soluble vitamin, important for the function of numerous proteins within the body, such as the coagulation factors, osteocalcin, and matrix-Gla protein. Vitamin K exists naturally as vitamin K1 (phylloquinone) and vitamin K2 (menaquinone). Vitamin K has a plethora of potential implications, including prevention and treatment of arterial calcifications, coronary heart disease, and cancer, improvements in bone strength, and reduced risks of fractures as well as improvements in insulin sensitivity. The survey was cross-sectional in design. Following participant self-administered enrolment in the study, data were collected by a questionnaire that assessed participants’ knowledge about vitamin k therapy. This study was conducted among the clinical dental students in different dental colleges across Chennai. The questionnaire consisted of 10 multiple-choice questions. From the results, it is seen that only 10% of the participants knew that Vitamin K2 can increase bone mass while most of them were unsure. Only 16% were aware that Vitamin K2 can improve the salivary buffering capacity via its impact on the secretion of calcium and inorganic phosphates while a large 65% were not aware. Only 18% knew that Vitamin K can actually build new dentin and 60% were unsure of the same. The level of knowledge and awareness of vitamin k therapy among dental students in dental students was poor. 

Vitamin K Influence on Cardiovascular Mortality in Chronic Hemodialysed Patients

2017 ◽  
Vol 68 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Daniela Radulescu ◽  
Andra Elena Balcangiu Stroescu ◽  
Catalin Pricop ◽  
Bogdan Geavlete ◽  
Carolina Negrei ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Cardiovascular Mortality ◽  
Dietary Intervention ◽  
Vitamin K2

Cardiovascular disease causes increased mortality in chronic hemodialysed patients. The decrease of vascular calcification is one of the main targets in the management of these patients. According to several experimental and clinical trials, choosing the proper diet and prescribing vitamin K2 supplements help to improve prognosis and decrease mortality, but further larger researchers are required to advocate the importance of this dietary intervention in hemodialysed population.

scholarly journals Vitamin K antagonist anticoagulant usage is associated with increased incidence and progression of osteoarthritis

2021 ◽  
Vol 80 (5) ◽  
pp. 598-604
Author(s):  
Cindy G Boer ◽  
Ingrid Szilagyi ◽  
N Long Nguyen ◽  
Tuhina Neogi ◽  
Ingrid Meulenbelt ◽  
...  
Keyword(s):  
Vitamin K ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Matrix Gla Protein ◽  
Study Cohort ◽  
Single Nucleotide Variants ◽  
Increased Risk ◽  
Coagulation Proteins ◽  
Clinical Prevention

ObjectivesVitamin K is hypothesised to play a role in osteoarthritis (OA) pathogenesis through effects on vitamin K-dependent bone and cartilage proteins, and therefore may represent a modifiable risk factor. A genetic variant in a vitamin K-dependent protein that is an essential inhibitor for cartilage calcification, matrix Gla protein (MGP), was associated with an increased risk for OA. Vitamin K antagonist anticoagulants (VKAs), such as warfarin and acenocoumarol, act as anticoagulants through inhibition of vitamin K-dependent blood coagulation proteins. VKAs likely also affect the functioning of other vitamin K-dependent proteins such as MGP.MethodsWe investigated the effect of acenocoumarol usage on progression and incidence of radiographic OA in 3494 participants of the Rotterdam Study cohort. We also examined the effect of MGP and VKORC1 single nucleotide variants on this association.ResultsAcenocoumarol usage was associated with an increased risk of OA incidence and progression (OR=2.50, 95% CI=1.94–3.20), both for knee (OR=2.34, 95% CI=1.67–3.22) and hip OA (OR=2.74, 95% CI=1.82–4.11). Among acenocoumarol users, carriers of the high VKORC1(BB) expression haplotype together with the MGP OA risk allele (rs1800801-T) had an increased risk of OA incidence and progression (OR=4.18, 95% CI=2.69–6.50), while this relationship was not present in non-users of that group (OR=1.01, 95% CI=0.78–1.33).ConclusionsThese findings support the importance of vitamin K and vitamin K-dependent proteins, as MGP, in the pathogenesis of OA. Additionally, these results may have direct implications for the clinical prevention of OA, supporting the consideration of direct oral anticoagulants in favour of VKAs.

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