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 journalArticleAcademicpeer-review

5 Citations (Web of Science)


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 languageEnglish
Pages (from-to)3171-3179
Number of pages9
JournalJournal of Nutrition
Issue number12
Publication statusPublished - Dec 2020


  • vitamin K
  • dp-ucMGP
  • vitamin D
  • echocardiography
  • mortality
  • cardiac structure
  • RISK

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