Abstract
Associations have been found between various micronutrients and cardio-metabolic outcomes.
Vitamin K deficiency has been associated with increased calcification of the main
arteries and with insulin resistance. The present study aimed to examine the association
between vitamin K intake and cardio-metabolic outcomes including cardiovascular disease,
type 2 diabetes and the metabolic syndrome.
A systematic review of the literature was performed in January 2010. Nine electronic
databases, and trial registers, reference lists of retrieved articles and citations
were searched. Intervention, cohort, case–control or cross-sectional studies in adults
were included if they examined the association between vitamin K levels (dietary intake,
biomarkers, supplements) on clinical outcomes relevant to cardio-metabolic disease.
Five studies met the inclusion criteria (1 trial, 4 cohort studies). Heterogeneity
of designs, exposures/interventions and outcomes meant that meta-analysis was not
possible. No associations were found between vitamin K1 intake and coronary heart
disease (CHD) (4 cohorts) or stroke (2 cohorts) in multivariate analyses. No differences
were seen in the prevalence of diabetes in a trial of vitamin K1 supplementation.
Two cohorts examined the effects of vitamin K2 intake on the incidence of CHD; both
found significant associations where higher vitamin K2 intake was associated with
fewer CHD events.
Few studies have examined the effects of vitamin K intake on clinical outcomes relevant
to cardio-metabolic disorders. None of the studies used biomarkers. Currently there
is no evidence for an effect of vitamin K1, but results for vitamin K2 look promising.
Further prospective studies are required to confirm these findings.
Abbreviations:
CI (95% confidence interval), CHD (coronary heart disease), CVD (cardiovascular disease), FFQ (Food Frequency Questionnaire), Gla (gamma-carboxyglutamyl acid), MGP (matrix Gla-protein), RCT (randomised controlled trial), Vitamin K1 (phylloquinone), Vitamin K2 (menaquinone)Keywords
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References
- From individual risk factors and the metabolic syndrome to global cardiometabolic risk.Eur Heart J Suppl. 2008; 10: B24-33
- A changing paradigm for prevention of cardiovascular disease: emergence of the metabolic syndrome as a multiplex risk factor.Eur Heart J Suppl. 2008; 10: B16-23
- The metabolic syndrome: a new worldwide definition.Lancet. 2005; 366: 1059-1062
- Harmonizing the metabolic syndrome.Circulation. 2009; 120: 1640-1645
- Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.N Engl J Med. 2001; 344: 3-10
- Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial.JAMA. 2005; 294: 2455-2464
- Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women.Arch Intern Med. 2008; 168 (Erratum in: Arch Intern Med. 2008;168(12):1276): 713-720
- Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis.Maturitas. 2010; 65: 225-236
- Vitamin E in the primary prevention of cardiovascular disease and cancer. The Women's Health Study: a randomized controlled trial.JAMA. 2005; 294: 56-65
- Determination of phylloquinone and menaquinones in food. Effect of food matrix on circulating vitamin K concentrations.Haemostasis. 2000; 30: 298-307
- Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods.Br J Nutr. 2000; 83: 389-399
- Comparative dietary intake and sources of phylloquinone (vitamin K1) among British adults in 1986–7 and 2000–1.Br J Nutr. 2006; 96: 1105-1115
- Vitamin K contents of meat, dairy, and fast food in the U.S. diet.J Agric Food Chem. 2006; 54: 463-467
- Vitamin K: The coagulation vitamin that became omnipotent.Thromb Haemost. 2007; 98: 120-125
- Vitamin K-dependent biosynthesis of γ-carboxyglutamic acid.Blood. 1999; 93: 1798-1808
- The role of Gla proteins in vascular calcification.Crit Rev Eukaryot Gene Expr. 1998; 8: 357-375
- Matrix Gla protein accumulates at the border of regions of calcification and normal tissue in the media of the arterial vessel wall.Biochem Biophys Res Commun. 2001; 289: 485-490
- Role of vitamin K and vitamin K-dependent proteins in vascular calcification.Z Kardiol. 2001; 90: 57-63
- Relationship between acute insulin response and vitamin K intake in healthy young male volunteers.Diabetes Nutr Metab. 1999; 12: 37-41
- Possible effects of one week vitamin K (menaquinone-4) tablets intake on glucose tolerance in healthy young male volunteers with different descarboxy prothrombin levels.Clin Nutr. 2000; 19: 259-263
- Phylloquinone intake, insulin sensitivity, and glycemic status in men and women.Am J Clin Nutr. 2008; 88: 210-215
- Effect of vitamin K supplementation on insulin resistance in older men and women.Diabetes Care. 2008; 31: 2092-2096
- Vitamin K status in human tissues: tissue-specific accumulation of phylloquinone and menaquinone-4.Br J Nutr. 1996; 75: 121-127
- Synthesis of γ-carboxylated polypeptides by α-cells of the pancreatic islets.Biochem Biophys Res Commun. 2001; 283: 454-459
Reeves BC, Deeks JJ, Higgins JPT, Wells GA. Chapter 13: Including non-randomised studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.0.1 [updated 2008] edition. The Cochrane Collaboration, 2008 [Available from: www.cochrane-handbook.org].
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from: www.ohri.ca/programs/clinical_epidemiology/oxford.htm 2008.
- Phylloquinone intake as a marker for coronary heart disease risk but not stroke in women.Eur J Clin Nutr. 2005; 59: 196-204
- Phylloquinone intake and risk of cardiovascular diseases in men.Nutr Metab Cardiovasc Dis. 2007 Jan; 17: 58-62
- A high menaquinone intake reduces the incidence of coronary heart disease.Nutr Metab Cardiovasc Dis. 2009 Sep; 19: 504-510
- Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study.J Nutr. 2004; 134: 3100-3105
- Vitamin K supplementation and progression of coronary artery calcium in older men and women.Am J Clin Nutr. 2009 Jun; 89: 1799-1807
- Dietary and nondietary determinants of vitamin K biochemical measures in men and women.J Nutr. 2002; 132: 1329-1334
- High dietary menaquinone intake is associated with reduced coronary calcification.Atherosclerosis. 2009; 203: 489-493
- Vitamin K1 intake and coronary calcification.Coron Artery Dis. 2005; 16: 199-203
Vermeer C. Clinical Trial on Beneficial Effects of Long Term Menaquinone-7 (Vitamin K2) Intake by Postmenopausal Women. ClinicalTrials.gov NCT00642551.
Kroon A. The Effects of Vitamin K2 Supplementation on the Progression of Coronary Artery Calcification. ClinicalTrials.gov NCT01002157.
- A practical guide to the dietary management of patients on warfarin.Nutr Rev. 1999; 57: 288-296
Article info
Publication history
Published online: June 03, 2010
Accepted:
May 18,
2010
Received in revised form:
May 18,
2010
Received:
May 13,
2010
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
