普通高血压成人中低维生素K1和维生素D状态与首次中风的联合关联：中国卒中一级预防试验（CSPPT）的结果

Joint Association of Low Vitamin K1 and D Status With First Stroke in General Hypertensive Adults: Results From the China Stroke Primary Prevention Trial (CSPPT).

作者信息

Wei Yaping, Ma Hai, Xu Benjamin, Wang Zhuo, He Qiangqiang, Liu Lishun, Zhou Ziyi, Song Yun, Chen Ping, Li Jianping, Zhang Yan, Mao Guangyun, Wang Binyan, Tang Genfu, Qin Xianhui, Zhang Hao, Xu Xiping, Huo Yong, Guo Huiyuan

机构信息

Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China.

Rongcheng Center for Disease Control and Prevention, Rongcheng, China.

出版信息

Front Neurol. 2022 May 12;13:881994. doi: 10.3389/fneur.2022.881994. eCollection 2022.

DOI:10.3389/fneur.2022.881994

PMID:35645985

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9135055/

Abstract

BACKGROUND

Vitamin K plays a role in preventing vascular calcification and may have a synergetic influence with vitamin D on cardiovascular health. However, whether this relationship applies to stroke, especially in a high-risk population of hypertensive individuals, remains unclear. The present study aims to study the joint association of low vitamin K1 and D status with first stroke in general hypertensive adults.

METHODS

This study used a nested, case-control design with data from the China Stroke Primary Prevention Trial. The analysis included 604 first total stroke patients and 604 matched controls from a Chinese population with hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using conditional logistic regression.

RESULTS

There was a non-linear negative association between plasma vitamin K1 and the risk of first total stroke or ischemic stroke in the enalapril-only group. Compared to participants in vitamin K1 quartile 1, a significantly lower risk of total stroke ( = 0.58, 95% CI: 0.36, 0.91, = 0.020) or ischemic stroke ( = 0.34, 95% CI: 0.17, 0.63, < 0.001) was found in participants in vitamin K1 quartile 2-4 in the enalapril-only group. When further divided into four subgroups by 25(OH)D and vitamin K1, a significantly higher risk of total stroke or ischemic stroke was observed in participants with both low vitamin K1 and 25(OH)D compared to those with both high vitamin K1 and 25(OH)D in the enalapril-only group. No increased risk was observed in the groups low in one vitamin only.

CONCLUSION

Low concentrations of both vitamin K1 and 25(OH)D were associated with increased risk of stroke.

摘要

背景

维生素K在预防血管钙化中发挥作用，并且可能在心血管健康方面与维生素D具有协同影响。然而，这种关系是否适用于中风，尤其是在高血压高危人群中，仍不清楚。本研究旨在探讨维生素K1和D水平较低与一般高血压成年人首次中风的联合关联。

方法

本研究采用巢式病例对照设计，数据来自中国卒中一级预防试验。分析纳入了604例首次发生全脑中风的患者和604例来自中国高血压人群的匹配对照。使用条件逻辑回归计算比值比（OR）和95%置信区间。

结果

在仅使用依那普利的组中，血浆维生素K1与首次全脑中风或缺血性中风风险之间存在非线性负相关。与维生素K1四分位数1的参与者相比，仅使用依那普利组中维生素K1四分位数2 - 4的参与者发生全脑中风（ = 0.58，95% CI：0.36，0.91， = 0.020）或缺血性中风（ = 0.34，95% CI：0.17，0.63， < 0.001）的风险显著降低。当按25(OH)D和维生素K1进一步分为四个亚组时，仅使用依那普利组中维生素K1和25(OH)D均低的参与者与维生素K1和25(OH)D均高的参与者相比，发生全脑中风或缺血性中风的风险显著更高。仅一种维生素水平低的组未观察到风险增加。