From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
Hypertension. 2017 Jun;69(6):1165-1172. doi: 10.1161/HYPERTENSIONAHA.116.08869. Epub 2017 Apr 10.
Low vitamin D and K status are both associated with an increased cardiovascular risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K; however, a joint association with vascular health outcomes is largely unknown. To prospectively investigate whether the combination of low vitamin D and K status is associated with higher systolic and diastolic blood pressure in 402 participants and with incident hypertension in 231 participants free of hypertension at baseline. We used data from a subsample of the Longitudinal Aging Study Amsterdam, a population-based cohort of Dutch participants aged 55 to 65 years. Vitamin D and K status were assessed by 25-hydroxyvitamin D and dp-ucMGP (dephosphorylated uncarboxylated matrix gla protein) concentrations (high dp-ucMGP is indicative for low vitamin K status) in stored samples from 2002 to 2003. Vitamin D and K status were categorized into 25-hydroxyvitamin D <50/≥50 mmol/L and median dp-ucMGP <323/≥323 pmol/L. During a median follow-up of 6.4 years, 62% of the participants (n=143) developed hypertension. The combination of low vitamin D and K status was associated with increased systolic 4.8 mm Hg (95% confidence interval, 0.1-9.5) and diastolic 3.1 mm Hg (95% confidence interval, 0.5-5.7) blood pressure compared with high vitamin D and K status ( for interaction =0.013 for systolic blood pressure and 0.068 for diastolic blood pressure). A similar trend was seen for incident hypertension: hazard ratio=1.62 (95% confidence interval, 0.96-2.73) for the low vitamin D and K group. The combination of low vitamin D and K status was associated with increased blood pressure and a trend for greater hypertension risk.
维生素 D 和 K 水平低均与心血管风险增加相关。来自骨骼健康的实验研究的新证据表明维生素 D 和 K 之间存在相互作用;然而,它们与血管健康结果的联合关联在很大程度上尚不清楚。本研究前瞻性调查了 402 名参与者中维生素 D 和 K 状态均低与收缩压和舒张压升高的相关性,以及在 231 名基线时无高血压的参与者中与高血压发生的相关性。我们使用了阿姆斯特丹纵向老龄化研究的一个亚样本数据,该研究是一个针对荷兰 55 至 65 岁人群的基于人群的队列研究。2002 年至 2003 年,使用存储的样本检测了 25-羟维生素 D 和 dp-ucMGP(脱磷酸未羧化基质 gla 蛋白)浓度来评估维生素 D 和 K 状态(高 dp-ucMGP 表示低维生素 K 状态)。维生素 D 和 K 状态分为 25-羟维生素 D<50/≥50mmol/L 和 dp-ucMGP 中位数<323/≥323pmol/L。在中位随访 6.4 年期间,62%的参与者(n=143)发生了高血压。与高维生素 D 和 K 状态相比,维生素 D 和 K 状态均低与收缩压升高 4.8mmHg(95%置信区间,0.1-9.5)和舒张压升高 3.1mmHg(95%置信区间,0.5-5.7)相关(交互作用 P 值=0.013 用于收缩压,P 值=0.068 用于舒张压)。对于高血压发生也有类似的趋势:低维生素 D 和 K 组的危险比=1.62(95%置信区间,0.96-2.73)。维生素 D 和 K 状态均低与血压升高相关,并与更高的高血压风险相关。