Bøgh Andersen Ida, Brasen Claus Lohman, Nasimi Hashmatullah, Stougård Maria, Bliddal Mette, Green Anders, Schmedes Anne, Brandslund Ivan, Madsen Jonna Skov
Department of Clinical Biochemistry and Immunology, Lillebælt Hospital, Vejle, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
BMJ Open Diabetes Res Care. 2020 Mar;8(1). doi: 10.1136/bmjdrc-2019-000961.
Vitamin K has proposed beneficial effects on cardiovascular health. We investigated whether serum vitamin K was associated with prevalence of microangiopathy and/or macroangiopathy.
Serum vitamin K was quantified in 3239 individuals with and 3808 without diabetes enrolled in Vejle Diabetes Biobank (2007-2010). Each individual was assessed for microangiography and macroangiopathy at enrollment based on registered diagnoses in the Danish National Patient Registry according to the International Classification of Disease 8 (1977-1993) and 10 (since 1994). Using multinomial logistic regression, relative risk ratios (RRRs) were calculated within each group of individuals with and without diabetes. RRRs were estimated for microangiopathic/macroangiopathic status compared with individuals without complications as a function of 1 nmol/L increments in K. Adjustment for potential confounders was also performed.
Vitamin K (median) varied 0.86-0.95 nmol/L depending on diabetes, microangiopathic and macroangiopathic status. In individuals with diabetes, the crude RRR for only having microangiopathy was 1.05 (95% CI 0.98 to 1.12) and was found significant when adjusting 1.10 (95% CI 1.01 to 1.19). RRR for having only macroangiopathy was 0.89 (95% CI 0.77 to 1.03) and was again significant when adjusting 0.79 (95% CI 0.66 to 0.96). In individuals without diabetes, adjustments again led to similar estimates that was not significant. The adjusted RRR for having only macroangiopathy was 1.08 (95% CI 0.98 to 1.19).
Serum vitamin K levels were associated with microangiopathic and macroangiopathic status in individuals with diabetes, but considered of no clinical relevance. The clinical value of other candidate markers for vitamin K status needs to be evaluated in future studies.
维生素K对心血管健康具有潜在益处。我们研究了血清维生素K是否与微血管病变和/或大血管病变的患病率相关。
对韦勒糖尿病生物样本库中3239例糖尿病患者和3808例非糖尿病患者的血清维生素K进行定量分析（2007 - 2010年）。根据丹麦国家患者登记处按照国际疾病分类第8版（1977 - 1993年）和第10版（自1994年起）登记的诊断信息，在入组时对每位个体进行微血管造影和大血管病变评估。使用多项逻辑回归分析，在糖尿病患者组和非糖尿病患者组中分别计算相对风险比（RRR）。将微血管病变/大血管病变状态与无并发症个体进行比较，以每增加1 nmol/L的维生素K水平为函数，估计RRR。同时对潜在混杂因素进行校正。
根据糖尿病、微血管病变和大血管病变状态，维生素K（中位数）在0.86 - 0.95 nmol/L之间变化。在糖尿病患者中，仅患有微血管病变的粗RRR为1.05（95%置信区间0.98至1.12），校正后为1.10（95%置信区间1.01至1.19），差异有统计学意义。仅患有大血管病变的RRR为0.89（95%置信区间0.77至1.03），校正后为0.79（95%置信区间0.66至0.96），差异有统计学意义。在非糖尿病患者中，校正后得到的结果相似，但无统计学意义。仅患有大血管病变的校正RRR为1.08（95%置信区间0.98至1.19）。
糖尿病患者的血清维生素K水平与微血管病变和大血管病变状态相关，但无临床相关性。维生素K状态的其他候选标志物的临床价值有待未来研究评估。
