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High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial

BACKGROUND: Vascular calcifications are highly prevalent in hemodialysis patients. Dephosphorylated-uncarboxylated MGP (dp-ucMGP) was found to increase in vitamin K-deficient patients and may be associated with vascular calcifications. Supplementation of hemodialysis patients with vitamin K(2) (mena...

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Autores principales: Aoun, Mabel, Makki, Maha, Azar, Hiba, Matta, Hiam, Chelala, Dania Nehme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463325/
https://www.ncbi.nlm.nih.gov/pubmed/28592319
http://dx.doi.org/10.1186/s12882-017-0609-3
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author Aoun, Mabel
Makki, Maha
Azar, Hiba
Matta, Hiam
Chelala, Dania Nehme
author_facet Aoun, Mabel
Makki, Maha
Azar, Hiba
Matta, Hiam
Chelala, Dania Nehme
author_sort Aoun, Mabel
collection PubMed
description BACKGROUND: Vascular calcifications are highly prevalent in hemodialysis patients. Dephosphorylated-uncarboxylated MGP (dp-ucMGP) was found to increase in vitamin K-deficient patients and may be associated with vascular calcifications. Supplementation of hemodialysis patients with vitamin K(2) (menaquinone-7) has been studied in Europe with a maximum 61% drop of dp-ucMGP levels. The aim of this study is to assess first the drop of dp-ucMGP in an Eastern Mediterranean cohort after vitamin K(2) treatment and second the correlation between baseline dp-ucMGP and vascular calcification score. METHODS: This is a prospective, pre-post intervention clinical trial involving 50 hemodialysis patients who received daily 360 μg of menaquinone-7 for 4 weeks. At baseline they were assessed for plasma dp-ucMGP levels and vascular calcification scores (AC-24) as well as for other demographic, clinical and biological variables. Dp-ucMGP levels were measured a second time at 4 weeks. RESULTS: At baseline, dp-ucMGP levels were extremely elevated with a median of 3179.15 (1825.25; 4339.50) pM and correlated significantly with AC-24 (Spearman’s rho = 0.43, P = 0.002). Using a bivariate regression analysis, the association between dp-ucMGP levels and AC-24 was most significant when comparing dp-ucMGP levels less than 1000 to those more than 1000 pM (P = 0.02). Dp-ucMGP levels higher than 5000 pM were significantly associated with females, patients with recent fracture and patients with lower serum albumin (respectively P = 0.02, 0.004 and 0.046). The average drop of dp-ucMGP at 4 weeks of treatment was found to be 86% with diabetics having the lowest drop rate (P = 0.01). CONCLUSION: Vitamin K deficiency, as assessed by high dp-ucMGP levels, is profound in hemodialysis patients from the Eastern Mediterranean region and it is significantly correlated with vascular calcifications. Daily 360 μg of menaquinone-7, given for 4 weeks, effectively reduces dp-ucMGP in this population. Future studies are needed to assess the changes in vascular calcifications in hemodialysis patients treated with vitamin K(2) over a longer follow-up period. TRIAL REGISTRATION: The clinical trial was registered on clinicaltrials.gov (Identification number NCT02876354, on August 11, 2016).
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spelling pubmed-54633252017-06-08 High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial Aoun, Mabel Makki, Maha Azar, Hiba Matta, Hiam Chelala, Dania Nehme BMC Nephrol Research Article BACKGROUND: Vascular calcifications are highly prevalent in hemodialysis patients. Dephosphorylated-uncarboxylated MGP (dp-ucMGP) was found to increase in vitamin K-deficient patients and may be associated with vascular calcifications. Supplementation of hemodialysis patients with vitamin K(2) (menaquinone-7) has been studied in Europe with a maximum 61% drop of dp-ucMGP levels. The aim of this study is to assess first the drop of dp-ucMGP in an Eastern Mediterranean cohort after vitamin K(2) treatment and second the correlation between baseline dp-ucMGP and vascular calcification score. METHODS: This is a prospective, pre-post intervention clinical trial involving 50 hemodialysis patients who received daily 360 μg of menaquinone-7 for 4 weeks. At baseline they were assessed for plasma dp-ucMGP levels and vascular calcification scores (AC-24) as well as for other demographic, clinical and biological variables. Dp-ucMGP levels were measured a second time at 4 weeks. RESULTS: At baseline, dp-ucMGP levels were extremely elevated with a median of 3179.15 (1825.25; 4339.50) pM and correlated significantly with AC-24 (Spearman’s rho = 0.43, P = 0.002). Using a bivariate regression analysis, the association between dp-ucMGP levels and AC-24 was most significant when comparing dp-ucMGP levels less than 1000 to those more than 1000 pM (P = 0.02). Dp-ucMGP levels higher than 5000 pM were significantly associated with females, patients with recent fracture and patients with lower serum albumin (respectively P = 0.02, 0.004 and 0.046). The average drop of dp-ucMGP at 4 weeks of treatment was found to be 86% with diabetics having the lowest drop rate (P = 0.01). CONCLUSION: Vitamin K deficiency, as assessed by high dp-ucMGP levels, is profound in hemodialysis patients from the Eastern Mediterranean region and it is significantly correlated with vascular calcifications. Daily 360 μg of menaquinone-7, given for 4 weeks, effectively reduces dp-ucMGP in this population. Future studies are needed to assess the changes in vascular calcifications in hemodialysis patients treated with vitamin K(2) over a longer follow-up period. TRIAL REGISTRATION: The clinical trial was registered on clinicaltrials.gov (Identification number NCT02876354, on August 11, 2016). BioMed Central 2017-06-07 /pmc/articles/PMC5463325/ /pubmed/28592319 http://dx.doi.org/10.1186/s12882-017-0609-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Aoun, Mabel
Makki, Maha
Azar, Hiba
Matta, Hiam
Chelala, Dania Nehme
High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title_full High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title_fullStr High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title_full_unstemmed High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title_short High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K(2), A pre-post intervention clinical trial
title_sort high dephosphorylated-uncarboxylated mgp in hemodialysis patients: risk factors and response to vitamin k(2), a pre-post intervention clinical trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463325/
https://www.ncbi.nlm.nih.gov/pubmed/28592319
http://dx.doi.org/10.1186/s12882-017-0609-3
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