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维生素K补充与血管钙化:随机对照试验的系统评价和荟萃分析

Vitamin K supplementation and vascular calcification: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Li Te, Wang Yun, Tu Wei-Ping

机构信息

Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

出版信息

Front Nutr. 2023 May 12;10:1115069. doi: 10.3389/fnut.2023.1115069. eCollection 2023.

Abstract

BACKGROUND

Vascular calcification (VC) is a complex process that has been linked to conditions including cardiovascular diseases and chronic kidney disease. There is an ongoing debate about whether vitamin K (VK) can effectively prevent VC. To assess the efficiency and safety of VK supplementation in the therapies of VC, we performed a systematic review and meta-analysis of recent studies.

METHODS

We searched major databases, including PubMed, the Cochrane Library, Embase databases, and Web of Science up until August 2022. 14 randomized controlled trials (RCTs) describing the outcomes of treatment for VK supplementation with VC have been included out of 332 studies. The results were reported in the change of coronary artery calcification (CAC) scores, other artery and valve calcification, vascular stiffness, and dephospho-uncarboxylated matrix Gla protein (dp-ucMGP). The reports of severe adverse events were recorded and analyzed.

RESULTS

We reviewed 14 RCTs, comprising a total of 1,533 patients. Our analysis revealed that VK supplementation has a significant effect on CAC scores, slowing down the progression of CAC [ = 34%, MD= -17.37, 95% CI (-34.18, -0.56), = 0.04]. The study found that VK supplementation had a significant impact on dp-ucMGP levels, as compared to the control group, where those receiving VK supplementation had lower values [ = 71%, MD = -243.31, 95% CI (-366.08, -120.53), = 0.0001]. Additionally, there was no significant difference in the adverse events between the groups [ = 31%, RR = 0.92, 95% CI (-0.79,1.07), = 0.29].

CONCLUSION

VK may have therapeutic potential for alleviating VC, especially CAC. However, more rigorously designed RCTs are required to verify the benefits and efficacy of VK therapy in VC.

摘要

背景

血管钙化(VC)是一个复杂的过程,与包括心血管疾病和慢性肾病在内的多种病症相关。关于维生素K(VK)能否有效预防血管钙化,目前仍存在争议。为评估补充VK在血管钙化治疗中的有效性和安全性,我们对近期研究进行了系统评价和荟萃分析。

方法

我们检索了主要数据库,包括截至2022年8月的PubMed、Cochrane图书馆、Embase数据库和Web of Science。在332项研究中,纳入了14项描述补充VK治疗血管钙化结果的随机对照试验(RCT)。结果以冠状动脉钙化(CAC)评分、其他动脉和瓣膜钙化、血管僵硬度以及去磷酸化未羧化基质Gla蛋白(dp-ucMGP)的变化来报告。记录并分析严重不良事件的报告。

结果

我们回顾了14项RCT,共纳入1533例患者。我们的分析显示,补充VK对CAC评分有显著影响,减缓了CAC的进展[ = 34%,MD = -17.37,95%CI(-34.18,-0.56), = 0.04]。研究发现,与对照组相比,补充VK对dp-ucMGP水平有显著影响,补充VK的患者其dp-ucMGP水平较低[ = 71%,MD = -243.31,95%CI(-366.08,-120.53), = 0.0001]。此外,两组之间不良事件无显著差异[ = 31%,RR = 0.92,95%CI(-0.79,1.07), = 0.29]。

结论

VK可能具有缓解血管钙化,尤其是冠状动脉钙化的治疗潜力。然而,需要更严格设计的随机对照试验来验证VK治疗血管钙化的益处和疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3f4/10218696/6567ede8e798/fnut-10-1115069-g0001.jpg

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