Cundiff David K, Agutter Paul S
Internal Medicine, LA County + USC Medical Center (Retired).
Formerly with Theoretical Medicne and Biology Group, Formerly University of Edinburgh.
Cureus. 2016 Aug 24;8(8):e748. doi: 10.7759/cureus.748.
Nutrition researchers recently recognized that deficiency of vitamin K2 (menaquinone: MK-4-MK-13) is widespread and contributes to cardiovascular disease (CVD). The deficiency of vitamin K2 or vitamin K inhibition with warfarin leads to calcium deposition in the arterial blood vessels.
Using publicly available sources, we collected food commodity availability data and derived nutrient profiles including vitamin K2 for people from 168 countries. We also collected female and male cohort data on early death from CVD (ages 15-64 years), insufficient physical activity, tobacco, biometric CVD risk markers, socioeconomic risk factors for CVD, and gender. The outcome measures included (1) univariate correlations of early death from CVD with each risk factor, (2) a multiple regression-derived formula relating early death from CVD (dependent variable) to macronutrient profile, vitamin K1 and K2 and other risk factors (independent variables), (3) for each risk factor appearing in the multiple regression formula, the portion of CVD risk attributable to that factor, and (4) similar univariate and multivariate analyses of body mass index (BMI), fasting blood sugar (FBS) (simulated from diabetes prevalence), systolic blood pressure (SBP), and cholesterol/ HDL-C ratio (simulated from serum cholesterol) (dependent variables) and dietary and other risk factors (independent variables).
Female and male cohorts in countries that have vitamin K2 < 5µg per 2000 kcal/day per capita (n = 70) had about 2.2 times the rate of early CVD deaths as people in countries with > 24 µg/day of vitamin K2 per 2000 kcal/day (n = 72). A multiple regression-derived formula relating early death from CVD to dietary nutrients and other risk factors accounted for about 50% of the variance between cohorts in early CVD death. The attributable risks of the variables in the CVD early death formula were: too much alcohol (0.38%), too little vitamin K2 (6.95%), tobacco (6.87%), high blood pressure (9.01%), air pollution (9.15%), early childhood death (3.64%), poverty (7.66%), and male gender (6.13%).
Worldwide dietary vitamin K2 data derived from food commodities add much understanding to the analysis of CVD risk factors and the etiology of CVD. Vitamin K2 in food products should be systematically quantified. Public health programs should be considered to increase the intake of vitamin K2-containing fermented plant foods such as sauerkraut, miso, and natto.
营养研究人员最近认识到，维生素K2（甲萘醌：MK - 4至MK - 13）缺乏症普遍存在，并会导致心血管疾病（CVD）。维生素K2缺乏或使用华法林抑制维生素K会导致钙在动脉血管中沉积。
我们利用公开资料收集了168个国家的食品商品供应数据，并得出了包括维生素K2在内的人群营养概况。我们还收集了关于心血管疾病早期死亡（15 - 64岁）、身体活动不足、烟草使用、心血管疾病生物标志物风险、心血管疾病社会经济风险因素以及性别的男女队列数据。结果指标包括：（1）心血管疾病早期死亡与各风险因素的单变量相关性；（2）一个多元回归得出的公式，将心血管疾病早期死亡（因变量）与常量营养素概况、维生素K1和K2以及其他风险因素（自变量）联系起来；（3）多元回归公式中出现的每个风险因素导致的心血管疾病风险比例；（4）对体重指数（BMI）、空腹血糖（FBS）（根据糖尿病患病率模拟）、收缩压（SBP）以及胆固醇/高密度脂蛋白胆固醇比值（根据血清胆固醇模拟）（因变量）和饮食及其他风险因素（自变量）进行类似的单变量和多变量分析。
在人均每天每2000千卡维生素K2 < 5微克的国家（n = 70），男女队列的心血管疾病早期死亡率约为维生素K2含量> 24微克/天每2000千卡的国家（n = 72）人群的2.2倍。一个将心血管疾病早期死亡与饮食营养素和其他风险因素联系起来的多元回归公式解释了各队列中心血管疾病早期死亡差异的约50%。心血管疾病早期死亡公式中各变量的归因风险分别为：饮酒过量（0.38%）、维生素K2摄入过少（6.95%）、烟草使用（6.87%）、高血压（9.01%）、空气污染（9.15%）、儿童早期死亡（3.64%）、贫困（7.66%）以及男性（6.13%）。
从食品商品中得出的全球膳食维生素K2数据为心血管疾病风险因素分析和心血管疾病病因学研究提供了更多认识。食品中的维生素K2应进行系统量化。应考虑实施公共卫生项目，以增加诸如酸菜、味噌和纳豆等含维生素K2的发酵植物性食品的摄入量。
