Shea M K, Cushman M, Booth S L, Burke G L, Chen H, Kritchevsky S B
Kyla Shea, PhD, USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA, E-mail:
Thromb Haemost. 2014 Sep 2;112(3):438-44. doi: 10.1160/TH13-12-1003. Epub 2014 May 22.
Vitamin K is integral to haemostatic function, and in vitro and animal experiments suggest that vitamin K can suppress production of inflammatory cytokines. To test the hypothesis that higher vitamin K status is associated with lower haemostatic activation and inflammation in community-dwelling adults, we analysed the cross-sectional association between serum phylloquinone (vitamin K1) with haemostatic and inflammatory biomarkers in 662 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) [mean (SD) age=62 (10) years; 46% female; 37% Caucasian, 25% African-American, 25% Hispanic, 13% Chinese-American]. Following adjustment for demographic and lifestyle characteristics, medication use, triglycerides and body mass index, those in the highest quartile of serum phylloquinone had significantly lower circulating interleukin-6 [adjusted mean (SEM) pmol/l: quartile 4 (Q4)=1.22 (0.07), quartile 1 (Q1)=1.45 (0.07); p-trend<0.01], C-reactive protein [adjusted mean (SEM) mg/dl: Q4=1.57 (0.11), Q1=2.08 (0.18); p-trend=0.02], soluble intercellular adhesion molecule-1 [adjusted mean (SEM) ng/ml: Q4=247 (11), Q1=288 (11); p-trend=0.02], and plasmin-antiplasmin complex [adjusted mean (SEM) nmol/l: Q4=4.02 (0.1), Q1=4.31 (0.1), p-trend=0.04]. We detected an interaction between age and serum phylloquinone with respect to factor VIII and D-dimer (interaction p-values=0.03 and 0.09, respectively). Among participants ≥70 years, serum phylloquinone was inversely associated with factor VIII activity (p-trend=0.06) and positively associated with D-dimer (p-trend=0.01), but was not associated with either marker among participants <70 years (both p≥0.38). In contrast, dietary phylloquinone intake was not associated with any inflammatory or haemostatic biomarker evaluated (all p-trend>0.11). These findings are consistent with laboratory-based studies that suggest a possible anti-inflammatory role for vitamin K. Whether or not these associations predict clinical outcomes linked to elevated inflammation or haemostatic activation remains to be determined.
维生素K对止血功能至关重要，体外和动物实验表明维生素K可抑制炎性细胞因子的产生。为验证在社区居住的成年人中，较高的维生素K水平与较低的止血激活和炎症反应相关这一假设，我们分析了动脉粥样硬化多族裔研究（MESA）中662名参与者的血清叶绿醌（维生素K1）与止血和炎症生物标志物之间的横断面关联[平均（标准差）年龄 = 62（10）岁；46%为女性；37%为白种人，25%为非裔美国人，25%为西班牙裔，13%为华裔美国人]。在对人口统计学和生活方式特征、药物使用、甘油三酯和体重指数进行调整后，血清叶绿醌处于最高四分位数的参与者，其循环白细胞介素-6水平显著较低[调整后均值（标准误）pmol/L：四分位数4（Q4）= 1.22（0.07），四分位数1（Q1）= 1.45（0.07）；p趋势<0.01]、C反应蛋白[调整后均值（标准误）mg/dl：Q4 = 1.57（0.11），Q1 = 2.08（0.18）；p趋势 = 0.02]、可溶性细胞间黏附分子-1[调整后均值（标准误）ng/ml：Q4 = 247（11），Q1 = 288（11）；p趋势 = 0.02]以及纤溶酶 - 抗纤溶酶复合物[调整后均值（标准误）nmol/L：Q4 = 4.02（0.1），Q1 = 4.31（0.1），p趋势 = 0.04]。我们检测到年龄与血清叶绿醌在因子VIII和D - 二聚体方面存在相互作用（相互作用p值分别为0.03和0.09）。在年龄≥70岁的参与者中，血清叶绿醌与因子VIII活性呈负相关（p趋势 = 0.06），与D - 二聚体呈正相关（p趋势 = 0.01），但在年龄<70岁的参与者中，血清叶绿醌与这两种标志物均无关联（p均≥0.38）。相比之下，膳食叶绿醌摄入量与所评估的任何炎症或止血生物标志物均无关联（所有p趋势>0.11）。这些发现与基于实验室的研究一致，提示维生素K可能具有抗炎作用。这些关联是否能预测与炎症或止血激活升高相关的临床结局仍有待确定。
