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

Elisa Dal Canto; Joline W. J. Beulens; Petra Elders; Femke Rutters; Coen D. A. Stehouwer; Amber A. van der Heijden; Adriana J. van Ballegooijen

doi:10.1093/jn/nxaa293

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

Elisa Dal Canto, Joline W. J. Beulens^*, Petra Elders, Femke Rutters, Coen D. A. Stehouwer, Amber A. van der Heijden, Adriana J. van Ballegooijen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

5 Citations (Web of Science)

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/m(2)), 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/m(2.7); 95% CI: 1.8, 10.0 g/m(2.7)). 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.

Original language	English
Pages (from-to)	3171-3179
Number of pages	9
Journal	Journal of Nutrition
Volume	150
Issue number	12
DOIs	https://doi.org/10.1093/jn/nxaa293
Publication status	Published - Dec 2020

Keywords

vitamin K
dp-ucMGP
vitamin D
echocardiography
mortality
cardiac structure
MATRIX GLA PROTEIN
POSTMENOPAUSAL WOMEN
JOINT ASSOCIATION
FOLLOW-UP
DISEASE
SUPPLEMENTATION
RISK
MENAQUINONE
PROGRESSION
CALCIUM

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10.1093/jn/nxaa293Licence: CC BY-NC

Cite this

Dal Canto, E., Beulens, J. W. J., Elders, P., Rutters, F., Stehouwer, C. D. A., van der Heijden, A. A., & van Ballegooijen, A. J. (2020). 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. Journal of Nutrition, 150(12), 3171-3179. https://doi.org/10.1093/jn/nxaa293

@article{0dce4e7ba8544663a08e3026437d596b,

title = "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",

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/m(2)), 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/m(2.7); 95% CI: 1.8, 10.0 g/m(2.7)). 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.",

keywords = "vitamin K, dp-ucMGP, vitamin D, echocardiography, mortality, cardiac structure, MATRIX GLA PROTEIN, POSTMENOPAUSAL WOMEN, JOINT ASSOCIATION, FOLLOW-UP, DISEASE, SUPPLEMENTATION, RISK, MENAQUINONE, PROGRESSION, CALCIUM",

author = "{Dal Canto}, Elisa and Beulens, {Joline W. J.} and Petra Elders and Femke Rutters and Stehouwer, {Coen D. A.} and {van der Heijden}, {Amber A.} and {van Ballegooijen}, {Adriana J.}",

year = "2020",

month = dec,

doi = "10.1093/jn/nxaa293",

language = "English",

volume = "150",

pages = "3171--3179",

journal = "Journal of Nutrition",

issn = "0022-3166",

publisher = "Oxford University Press",

number = "12",

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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. / Dal Canto, Elisa; Beulens, Joline W. J.; Elders, Petra et al.

In: Journal of Nutrition, Vol. 150, No. 12, 12.2020, p. 3171-3179.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The Association of Vitamin D and Vitamin K Status with Subclinical Measures of Cardiovascular Health and All-Cause Mortality in Older Adults

T2 - The Hoorn Study

AU - Dal Canto, Elisa

AU - Beulens, Joline W. J.

AU - Elders, Petra

AU - Rutters, Femke

AU - Stehouwer, Coen D. A.

AU - van der Heijden, Amber A.

AU - van Ballegooijen, Adriana J.

PY - 2020/12

Y1 - 2020/12

N2 - 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/m(2)), 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/m(2.7); 95% CI: 1.8, 10.0 g/m(2.7)). 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.

AB - 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/m(2)), 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/m(2.7); 95% CI: 1.8, 10.0 g/m(2.7)). 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.

KW - vitamin K

KW - dp-ucMGP

KW - vitamin D

KW - echocardiography

KW - mortality

KW - cardiac structure

KW - MATRIX GLA PROTEIN

KW - POSTMENOPAUSAL WOMEN

KW - JOINT ASSOCIATION

KW - FOLLOW-UP

KW - DISEASE

KW - SUPPLEMENTATION

KW - RISK

KW - MENAQUINONE

KW - PROGRESSION

KW - CALCIUM

U2 - 10.1093/jn/nxaa293

DO - 10.1093/jn/nxaa293

M3 - Article

C2 - 33119768

VL - 150

SP - 3171

EP - 3179

JO - Journal of Nutrition

JF - Journal of Nutrition

SN - 0022-3166

IS - 12

ER -