Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
School of Medicine, University of Western Australia, Perth, Australia.
Eur J Epidemiol. 2021 Oct;36(10):1005-1014. doi: 10.1007/s10654-021-00806-9. Epub 2021 Sep 30.
Reported associations between vitamin K and both all-cause and cause-specific mortality are conflicting. The 56,048 participants from the Danish Diet, Cancer, and Health prospective cohort study, with a median [IQR] age of 56 [52-60] years at entry and of whom 47.6% male, were followed for 23 years, with 14,083 reported deaths. Of these, 5015 deaths were CVD-related, and 6342 deaths were cancer-related. Intake of vitamin K (phylloquinone) was estimated from a food-frequency questionnaire (FFQ), and its relationship with mortality outcomes was investigated using Cox proportional hazards models. A moderate to high (87-192 µg/d) intake of vitamin K was associated with a lower risk of all-cause [HR (95%CI) for quintile 5 vs quintile 1: 0.76 (0.72, 0.79)], cardiovascular disease (CVD)-related [quintile 5 vs quintile 1: 0.72 (0.66, 0.79)], and cancer-related mortality [quintile 5 vs quintile 1: 0.80 (0.75, 0.86)], after adjusting for demographic and lifestyle confounders. The association between vitamin K intake and cardiovascular disease-related mortality was present in all subpopulations (categorised according to sex, smoking status, diabetes status, and hypertension status), while the association with cancer-related mortality was only present in current/former smokers (p for interaction = 0.002). These findings suggest that promoting adequate intakes of foods rich in vitamin K may help to reduce all-cause, CVD-related, and cancer-related mortality at the population level.
报告的维生素 K 与全因和特定原因死亡率之间的关联存在冲突。来自丹麦饮食、癌症和健康前瞻性队列研究的 56048 名参与者,入组时的中位(IQR)年龄为 56 [52-60] 岁,其中 47.6%为男性,随访 23 年,报告了 14083 例死亡。其中,5015 例死亡与心血管疾病(CVD)相关,6342 例死亡与癌症相关。维生素 K(叶绿醌)的摄入量通过食物频率问卷(FFQ)进行估计,并使用 Cox 比例风险模型研究其与死亡率结局的关系。中等到高(87-192μg/d)的维生素 K 摄入量与全因[风险比(95%CI)第 5 五分位数与第 1 五分位数:0.76(0.72,0.79)]、心血管疾病(CVD)相关[第 5 五分位数与第 1 五分位数:0.72(0.66,0.79)]和癌症相关死亡率[第 5 五分位数与第 1 五分位数:0.80(0.75,0.86)]降低相关,在调整人口统计学和生活方式混杂因素后。维生素 K 摄入量与心血管疾病相关死亡率之间的关联存在于所有亚人群(根据性别、吸烟状况、糖尿病状况和高血压状况进行分类),而与癌症相关死亡率之间的关联仅存在于当前/以前吸烟者(交互作用的 p 值=0.002)。这些发现表明,促进富含维生素 K 的食物的充足摄入可能有助于降低人群的全因、CVD 相关和癌症相关死亡率。