Document Detail


Vitamin K, vertebral fractures, vascular calcifications and mortality: Vitamin K Italian (VIKI) dialysis study.
MedLine Citation:
PMID:  22692665     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Vitamin K (vitamin K1 or phylloquinone and vitamin K2, a series of menaquinones - MKs) is involved in the production of bone and matrix Gla proteins, regulating bone and vascular calcification. Low vitamin K concentrations are associated with increased risks of fractures and vascular calcification, frequent complications in hemodialysis patients. We carried out an observational study to establish the prevalence of vitamin K deficiency and to assess the relationship between vitamin K status, vertebral fractures, vascular calcification and survival in 387 patients on hemodialysis for ≥1year. We determined plasma levels of vitamin K compound, bone-Gla-protein, matrix-Gla-protein, and routine biochemistry. Vertebral fractures (reduction in vertebral body height by ≥20%), aortic and iliac calcifications were also investigated in a spine (D5-L4) radiograph. Three-year patients' survival was analyzed. Important proportions of patients had deficiency of MK7 (35.4%), vitamin K1 (23.5%) and MK4 (14.5%). 55.3% of patients had vertebral fractures, 80.6% had abdominal aorta calcification and 56.1% had iliac calcification. Vitamin K1 deficiency was the strongest predictor of vertebral fractures (OR 2.94 95%CI 1.38-6.26). MK4 deficiency was a predictor of aortic calcification (OR 2.82 95%CI 1.14-7.01), whereas MK5 deficiency actually protected against it (OR 0.38 95%CI 0.15-0.95). MK7 deficiency was a predictor of iliac calcification (OR 1.64 95%CI 1.03-2.60). The presence of vertebral fractures was also a predictor of vascular calcifications (OR 1.76 95%CI 1.00-3.08). Increased alkaline phosphatase and C reactive protein (CRP), age, cerebrovascular events were predictors of mortality. Our study suggests that the vitamin K system may be important for preserving bone mass and avoiding vascular calcification in hemodialysis patients, pointing out a possible role of vitamin K in bone and vascular health. Based on our results, we suggest that the general population should also be studied for vitamin K deficiency as a possible cause of both vertebral fractures and vascular calcification. © 2012 American Society for Bone and Mineral Research.
Authors:
Maria Fusaro; Marianna Noale; Valentina Viola; Francesco Galli; Giovanni Tripepi; Nicola Vajente; Mario Plebani; Martina Zaninotto; Giuseppe Guglielmi; Diego Miotto; Luca Dalle Carbonare; Angela D'Angelo; Agostino Naso; Cristina Grimaldi; Davide Miozzo; Sandro Giannini; Maurizio Gallieni;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-12
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  -     ISSN:  1523-4681     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Society for Bone and Mineral Research.
Affiliation:
Consiglio Nazionale delle Ricerche (CNR) - Institute of Neuroscience, Aging Section, Padua, Italy. dante.lucia@libero.it.
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