Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study

Abstract

Vitamin K-dependent proteins, including matrix Gla-protein, have been shown to inhibit vascular calcification. Activation of these proteins via carboxylation depends on the availability of vitamin K. We examined whether dietary intake of phylloquinone (vitamin K-1) and menaquinone (vitamin K-2) were related to aortic calcification and coronary heart disease (CHD) in the population-based Rotterdam Study. The analysis included 4807 subjects with dietary data and no history of myocardial infarction at baseline (1990-1993) who were followed until January 1, 2000. The risk of incident CHD, all-cause mortality, and aortic atherosclerosis was studied in tertiles of energy-adjusted vitamin K intake after adjustment for age, gender, BMI, smoking, diabetes, education, and dietary factors. The relative risk (RR) of CHD mortality was reduced in the mid and upper tertiles of dietary menaquinone compared to the lower tertile [RR = 0.73 (95% CI: 0.45, 1.17) and 0.43 (0.24, 0.77), respectively]. Intake of menaquinone was also inversely related to all-cause mortality [RR = 0.91 (0.75, 1.09) and 0.74 (0.59, 0.92), respectively] and severe aortic calcification [odds ratio of 0.71 (0.50, 1.00) and 0.48 (0.32, 0.71), respectively]. Phylloquinone intake was not related to any of the outcomes. These findings suggest that an adequate intake of menaquinone could be important for CHD prevention.

Vitamin K: an old vitamin in a new perspective

“…Vitamin K 2 even reduced the risk of severe arterial calcification by 52% (OR: 0.48). 43 Carboxylated MGP is an important inhibitor of vascular calcification. Accordingly, uncarboxylated MGP (ucMGP) is an independent risk factor for arteriosclerosis.…”

Vitamin K-dependent Proteins, Warfarin, and Vascular Calcification

“…Conversely, the administration of vitamin K1 allows for normal coagulation production, yet does not prevent peripheral vascular calcification (29). In the Rotterdam study, a large epidemiologic trial investigating the relationship of nutritional intake to cardiovascular disease, vitamin K2 intake was inversely related to both vascular calcification and mortality (30), whereas vitamin K1 intake seemed to have no relationship, a finding noted by others (31). These studies suggest that vitamin K2-dependent peripheral carboxylation protects the vasculature from calcification and raises important questions about the bioavailablity of vitamin K2.…”

Non Typical Risk Factors in Atherosclerosis and Coronary Disease. It Is Time to Open the Box and Look Outside

“…The population based Rotterdam study studied 4807 healthy men and women older than age 55 years, evaluating the relationship between dietary intake of vitamin K and aortic calcification, heart disease, and all-cause mortality. The study revealed that high dietary intake of vitamin K2-at least 32 mcg per day, with no intake of vitamin K1, was associated with a 50% reduction in death from cardiovascular issues related to arterial calcification and a 25% reduction in all-cause mortality [14].…”