Combined low vitamin D and K status amplifies mortality risk: a prospective study
European Journal of Nutrition https://doi.org/10.1007/s00394-020-02352-8
Adriana J. van Ballegooijen <1> • Joline W. J. Beulens <2> • Lyanne M. Kieneker <3> • Martin H. de Borst <4> • Ron T. Gansevoort <5> • Ido P. Kema <6> • Leon J. Schurgers <7> • Marc G. Vervloet <8> <9> • Stephan J. L. Bakker <10>
Objective To explore the association of both plasma vitamin D and K concentrations with all-cause mortality, cardiovascular mortality, and cardiovascular events in the general population.
Methods We studied 4742 participants of the Prevention of REnal and Vascular ENd-Stage Disease (PREVEND) Study. At baseline, vitamin D and K status was determined by measurement of 25-hydroxyvitamin D [25(OH)D] and dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), respectively. Patients were categorized into: 25(OH)D < 50 or > 50 nmol/L and dp-ucMGP < 361 or > 361 pmol/L with 25(OH)D > 75 nmol/L and dp-ucMGP < 361 pmol/L as reference. Cause of death was coded according to International Classification of Diseases 9&10 codes from the 2001-2003 examination until date of death/event or censoring date (January 1st, 2017).
Results Mean age was 52.6 ± 11.9 years and 2513 (53%) were female. During a median of 14.2 year follow-up, 620 participants died of which 142 were due to cardiovascular causes.
Combined low vitamin D and K status was present in 970 participants (20%) and was associated with a greater risk of all-cause mortality compared to high vitamin D and high vitamin K status group (n = 1424) after adjusting for potential confounders: hazard ratio 1.46 (95% confidence intervals 1.12-1.90). We observed similar trends, albeit non-significant for cardiovascular mortality, and cardiovascular events: 1.42 (0.79-2.55), 1.28 (0.93-1.77), respectively.
Conclusions Combined low vitamin D and K status are associated with increased all-cause mortality risk and possibly with cardiovascular mortality and cardiovascular events compared with adequate vitamin D and K status. Future studies should investigate the effect of combined vitamin D and K supplementation on clinical outcomes.
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VitaminDWiki - items in both categories Vitamin D and Mortality
VitaminDWiki - Some all-cause Mortality
- Low levels of vitamin D associated with all cause mortality – Oct 2012
- All-cause mortality is related to low Magnesium, rather than low Vitamin D – April 2015
- Low vitamin D associated with all-cause mortality and frailty – Mar 2011
- Dr. Grant on vitamin D and mortality in VitaminDWiki - which includes the following chart