Department of Internal Medicine, Maastricht University Medical Centre (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
Eur J Clin Invest. 2010 Apr;40(4):344-9. doi: 10.1111/j.1365-2362.2010.02275.x.
Vascular calcification in humans is associated with an increased cardiovascular risk. Carboxylated matrix Gla protein (cMGP) inhibits vascular calcification. Vitamin K is an essential cofactor for the activation of uncarboxylated matrix Gla protein (ucMGP). It has been suggested that patients on long-term treatment with vitamin K antagonists develop aortic valve calcifications because of lower levels of circulating MGP. We therefore hypothesized that arterial calcification and a low vitamin K status are associated with ucMGP. To that aim, we measured arterial calcium scores, the osteocalcin ratio (OCR), as a proxy for vitamin K status, and ucMGP.
In 36 hypertensive patients, we determined the Agatston score with computer tomography scans of the abdominal aorta, carotid and coronary arteries. The total calcium score was calculated as the sum of the separate Z-scores.
The total calcium Z-score was significantly correlated to age (r = 0.683, P < 0.001), smoking (r = 0.372, P = 0.026), total cholesterol (r = 0.353, P = 0.034), LDL cholesterol (r = 0.490, P = 0.003), triglycerides (r = 0.506, P = 0.002), fasting glucose (r = 0.454, P = 0.005), systolic blood pressure (r = 0.363, P = 0.029) and pulse pressure (r = 0.685, P < 0.001). In multivariate regression analyses, OCR and total calcium score were significantly associated with ucMGP.
We found a positive association of total arterial calcium score and a high OCR (reflecting low vitamin K status) with ucMGP serum levels. This warrants further studies to explore the pathophysiological background of this phenomenon.
人类的血管钙化与心血管风险增加有关。羧化基质 Gla 蛋白（cMGP）可抑制血管钙化。维生素 K 是未羧化基质 Gla 蛋白（ucMGP）激活的必需辅助因子。有人认为，长期接受维生素 K 拮抗剂治疗的患者由于循环 MGP 水平较低而发展为主动脉瓣钙化。因此，我们假设动脉钙化和维生素 K 状态较低与 ucMGP 有关。为此，我们测量了动脉钙分数、骨钙素比（OCR），作为维生素 K 状态的替代指标，以及 ucMGP。
在 36 例高血压患者中，我们通过计算机断层扫描（CT）扫描腹部主动脉、颈动脉和冠状动脉来确定 Agatston 评分。总钙评分是通过分别的 Z 分数之和计算得出的。
总钙 Z 评分与年龄（r = 0.683，P < 0.001）、吸烟（r = 0.372，P = 0.026）、总胆固醇（r = 0.353，P = 0.034）、低密度脂蛋白胆固醇（r = 0.490，P = 0.003）、甘油三酯（r = 0.506，P = 0.002）、空腹血糖（r = 0.454，P = 0.005）、收缩压（r = 0.363，P = 0.029）和脉压（r = 0.685，P < 0.001）呈显著正相关。在多变量回归分析中，OCR 和总钙评分与 ucMGP 显著相关。
我们发现总动脉钙评分和高 OCR（反映维生素 K 状态较低）与 ucMGP 血清水平呈正相关。这需要进一步的研究来探讨这种现象的病理生理背景。
