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Title: Associations between vitamin K status and hemostatic and inflammatory biomarkers in community-dwelling adults: The multi-ethnic study of atherosclerosis

Author
item SHEA, KYLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CUSHMAN, MARY - University Of Vermont
item BOOTH, SARAH - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item BURKE, GREGORY - Wake Forest School Of Medicine
item CHEN, HAIYING - Wake Forest School Of Medicine
item KRITCHEVSKY, STEPHEN - Wake Forest School Of Medicine

Submitted to: Thrombosis and Haemostasis
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/15/2014
Publication Date: 5/22/2014
Citation: Shea, K.M., Cushman, M., Booth, S.L., Burke, G.L., Chen, H., Kritchevsky, S. 2014. Associations between vitamin K status and hemostatic and inflammatory biomarkers in community-dwelling adults: The multi-ethnic study of atherosclerosis. Thrombosis and Haemostasis. DOI: 10.1160/TH13-12-1003.

Interpretive Summary: We investigated whether vitamin K nutritional status was associated with hemostatic activation (an indication of blood clotting function) and inflammation in a multi-ethnic group of community-dwelling adults. Individuals with higher circulating vitamin K concentrations had lower concentrations of several, but not all, inflammatory and hemostatic markers in their blood (indicative of lower inflammation and hemostatic activation). The associations between vitamin K and certain hemostatic markers were more pronounced in the older adults. Self-reported dietary vitamin K intake was not associated with any inflammatory or hemostatic marker we analyzed. Whether or not the associations we found are applicable to clinical outcomes linked to elevated inflammation or hemostatic activation (such as heart disease) remains to be determined.

Technical Abstract: Vitamin K is integral to hemostatic function, and in vitro and animal experiments suggest that vitamin K can suppress production of inflammatory cytokines. To test the hypothesis that higher vitamin K status is associated with lower hemostasic activation and inflammation in community-dwelling adults. We analyzed the cross-sectional association between serum phylloquinone (vitamin K1) with hemostatic and inflammatory biomarkers in 662 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) (mean+/-SD age=62+/-10y; 46% female; 37% Caucasian, 25% African-American, 25% Hispanic, 13% Chinese-American). Following adjustment for demographic and lifestyle characteristics, medication use, triglycerides and BMI, those in the highest quartile of serum phylloquinone had significantly lower circulating interleukin-6 (adjusted mean+/-SEM pmol/L: quartile 4 (Q4)=1.23+/-0.07, quartile 1(Q1)=1.45+/-0.07; p-trend<0.01), CRP (adjusted mean+/-SEM mg/dl: Q4=1.56+/-0.11, Q1=2.11+/-0.18; p-trend=0.03), soluble intercellular adhesion molecule-1 (adjusted mean+/-SEM ng/ml: Q4=250+/-11, Q1=289+/-11; p-trend=0.01), and plasmin-antiplasmin complex (adjusted mean+/-SEM nmol/L: Q4=4.01+/-0.1, Q1=4.31+/-0.1, p-trend=0.03). We detected an interaction between age and serum phylloquinone with respect to factor VIII and D-dimer (interaction p-values=0.03 and 0.09 respectively). Among participants greater than or equal to 70y, serum phylloquinone was inversely associated with factor VIII activity (p-trend=0.03) and positively associated with D-dimer (p-trend=0.01), but was not associated with either marker among participants <70y (both p greater than or equal to 0.38). In contrast, dietary phylloquinone intake was not associated with any inflammatory or hemostatic biomarker evaluated (all p-trend>0.11). These findings are consistent with laboratory-based studies that suggest a possible anti-inflammatory role for vitamin K. Whether or not these associations predict clinical outcomes linked to elevated inflammation or hemostatic activation remains to be determined.