OP.7C.09] SYNERGISTIC EFFECT OF LOW K AND D VITAMIN STATUS ON ARTERIAL STIFFNESS IN A GENERAL POPULATION

Abstract

Objective: Both vitamins K and D are nutrients with pleiotropic functions in human tissues. The metabolic role of these vitamins overlaps considerably in calcium homeostasis. We analyzed their potential synergetic effect on arterial stiffness. Design and method: In a cross-sectional study, we analyzed aortic pulse wave velocity (aPWV) in 1023 subjects from the Czech post-MONICA study. Desphospho-uncarboxylated matrix γ-carboxyglutamate protein (dp-ucMGP), a biomarker of vitamin K status, was measured by sandwich ELISA, and 25-hydroxyvitamin D3 (25-OH-D3) by a commercial immunochemical assay. In a subsample of 431 subjects without chronic disease or pharmacotherapy, we detected rs2228570 polymorphism for the vitamin D receptor. Results: After adjustment for confounders, aPWV was independently associated with both factors: dp-ucMGP [β coefficient(SEM) = 13.91(4.87); p = 0.004] and 25-OH-D3 [0.624(0.28); p = 0.027]. In a further analysis, we divided subjects according to dp-ucMGP and 25-OH-D3 quartiles, resulting in 16 subgroups. The highest aPWV had subjects in the top quartile of dp-ucMGP plus bottom quartile of 25-OH-D3 (i.e. in those with insufficient status of both vitamin K and vitamin D), while the lowest aPVW had subjects in the bottom quartile of dp-ucMGP plus top quartile of 25-OH-D3 [9.8 (SD2.6) versus 6.6 (SD1.6) m/sec; p < 0.0001]. When we compared these extreme groups of vitamin K and D status, the adjusted odds ratio for aPWV less than 9.4 m/sec was 6.83 (95%CI:1.95–20.9). The aPWV was also significantly higher among subjects bearing the GG genotype of rs2228570, but only in those with a concomitantly poor vitamin K status. Conclusions: We confirmed substantial interaction of insufficient K and D vitamin status in terms of increased aortic stiffness.