Aaseth Jan O, Alehagen Urban, Opstad Trine Baur, Alexander Jan
Research Department, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway.
Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, N-2418 Elverum, Norway.
Biomedicines. 2023 Nov 27;11(12):3154. doi: 10.3390/biomedicines11123154.
The observation that the extent of artery calcification correlates with the degree of atherosclerosis was the background for the alternative treatment of cardiovascular disease with chelator ethylenediamine tetraacetate (EDTA). Recent studies have indicated that such chelation treatment has only marginal impact on the course of vascular disease. In contrast, endogenous calcium chelation with removal of calcium from the cardiovascular system paralleled by improved bone mineralization exerted, i.e., by matrix Gla protein (MGP) and osteocalcin, appears to significantly delay the development of cardiovascular diseases. After post-translational vitamin-K-dependent carboxylation of glutamic acid residues, MGP and other vitamin-K-dependent proteins (VKDPs) can chelate calcium through vicinal carboxyl groups. Dietary vitamin K is mainly provided in the form of phylloquinone from green leafy vegetables and as menaquinones from fermented foods. Here, we provide a review of clinical studies, addressing the role of vitamin K in cardiovascular diseases, and an overview of vitamin K kinetics and biological actions, including vitamin-K-dependent carboxylation and calcium chelation, as compared with the action of the exogenous (therapeutic) chelator EDTA. Consumption of vitamin-K-rich foods and/or use of vitamin K supplements appear to be a better preventive strategy than EDTA chelation for maintaining vascular health.
动脉钙化程度与动脉粥样硬化程度相关这一观察结果，是使用螯合剂乙二胺四乙酸（EDTA）对心血管疾病进行替代治疗的背景。近期研究表明，这种螯合治疗对血管疾病进程的影响甚微。相比之下，通过基质Gla蛋白（MGP）和骨钙素等实现的内源性钙螯合，即从心血管系统中去除钙并同时改善骨矿化，似乎能显著延缓心血管疾病的发展。在谷氨酸残基进行翻译后维生素K依赖性羧化后，MGP和其他维生素K依赖性蛋白（VKDPs）可通过相邻羧基螯合钙。膳食中的维生素K主要以绿叶蔬菜中的叶绿醌以及发酵食品中的甲基萘醌形式提供。在此，我们综述了关于维生素K在心血管疾病中作用的临床研究，并概述了维生素K的动力学和生物学作用，包括维生素K依赖性羧化和钙螯合，同时与外源性（治疗性）螯合剂EDTA的作用进行比较。食用富含维生素K的食物和/或使用维生素K补充剂，似乎是比EDTA螯合更好的维持血管健康的预防策略。
