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Circulating phylloquinone, inactive Matrix Gla protein and coronary heart disease risk: A two-sample Mendelian Randomization study.

Accepted version
Peer-reviewed

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Article

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Authors

Zwakenberg, Sabine R 
Sluijs, Ivonne 
Weiderpass, Elisabete 
EPIC-CVD consortium 

Abstract

BACKGROUND AND AIMS: Multiple observational studies and small-scale intervention studies suggest that high vitamin K intake is associated with improved markers for cardiovascular health. Circulating phylloquinone solely represents phylloquinone (vitamin K1) intake, while dephosphorylated uncarboxylated Matrix Gla Protein (dp-ucMGP) represents both phylloquinone and menaquinone (vitamin K2) intake. This study aims to investigate the causal relationship between genetically predicted vitamin K concentrations and the risk of CHD via a two-sample Mendelian Randomization approach. DESIGN: We used data from three studies: the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD case-cohort study, CARDIOGRAMplusC4D and the UK Biobank, resulting in 103,097 CHD cases. Genetically predicted vitamin K concentrations were measured using SNPs related to circulating phylloquinone and dp-ucMGP. We calculated a genetic risk score (GRS) including four SNPs (rs2108622, rs2192574, rs4645543 and rs6862071) related to circulating phylloquinone levels from a genome wide association study. Rs4236 was used as an instrumental variable for dp-ucMGP. Inverse-variance weighted (IVW) analysis was used to obtain Risk Ratios (RRs) for the causal relationship between phylloquinone and dp-ucMGP concentrations and CHD risk. RESULTS: Using the genetic score for circulating phylloquinone, we found that circulating phylloquinone was not causally related to CHD risk (RR 1.00 (95%-CI: 0.98; 1.04)). Lower genetically predicted dp-ucMGP concentration was associated with a lower CHD risk with a RR of 0.96 (95%-CI: 0.93; 0.99) for every 10 μg/L decrease in dp-ucMGP. CONCLUSIONS: This study did not confirm a causal relationship between circulating phylloquinone and lower CHD risk. However, lower dp-ucMGP levels may be causally related with a decreased CHD risk. This inconsistent result may reflect the influence of menaquinones in the association with CHD.

Description

Keywords

Coronary heart disease, Epidemiology, Matrix Gla protein, Mendelian randomization, Phylloquinone, Vitamin K, Adult, Aged, Biomarkers, Calcium-Binding Proteins, Coronary Disease, Extracellular Matrix Proteins, Female, Humans, Male, Mendelian Randomization Analysis, Middle Aged, Risk Assessment, Vitamin K 1, Matrix Gla Protein

Journal Title

Clin Nutr

Conference Name

Journal ISSN

0261-5614
1532-1983

Volume Title

39

Publisher

Elsevier BV
Sponsorship
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MR/L003120/1)
European Research Council (268834)
Medical Research Council (MC_UU_12015/5)
Medical Research Council (G0800270)
British Heart Foundation (None)
Medical Research Council (MC_UU_00002/7)
British Heart Foundation (RG/18/13/33946)
MRC (MC_UU_00006/3)
Wellcome Trust (204623/Z/16/Z)
Medical Research Council (G0800270/1)
Includes FP7, EU, MRC, NIHR and BHF