Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: the Hordaland Health Study Cohort

Teresa R Haugsgjerd, Grace M Egeland, Ottar K Nygård, Kathrine J Vinknes, Gerhard Sulo, Vegard Lysne, Jannicke Igland, Grethe S Tell, Teresa R Haugsgjerd, Grace M Egeland, Ottar K Nygård, Kathrine J Vinknes, Gerhard Sulo, Vegard Lysne, Jannicke Igland, Grethe S Tell

Abstract

Objective: The role of vitamin K in the regulation of vascular calcification is established. However, the association of dietary vitamins K1 and K2 with risk of coronary heart disease (CHD) is inconclusive.

Design: Prospective cohort study.

Setting: We followed participants in the community-based Hordaland Health Study from 1997 - 1999 through 2009 to evaluate associations between intake of vitamin K and incident (new onset) CHD. Baseline diet was assessed by a past-year food frequency questionnaire. Energy-adjusted residuals of vitamin K1 and vitamin K2 intakes were categorised into quartiles.

Participants: 2987 Norwegian men and women, age 46-49 years.

Methods: Information on incident CHD events was obtained from the nationwide Cardiovascular Disease in Norway (CVDNOR) Project. Multivariable Cox regression estimated HRs and 95% CIs with test for linear trends across quartiles. Analyses were adjusted for age, sex, total energy intake, physical activity, smoking and education. A third model further adjusted K1 intake for energy-adjusted fibre and folate, while K2 intake was adjusted for energy-adjusted saturated fatty acids and calcium.

Results: During a median follow-up time of 11 years, we documented 112 incident CHD cases. In the adjusted analyses, there was no association between intake of vitamin K1 and CHD (HRQ4vsQ1 = 0.92 (95% CI 0.54 to 1.57), p for trend 0.64), while there was a lower risk of CHD associated with higher intake of energy-adjusted vitamin K2 (HRQ4vsQ1 = 0.52 (0.29 to 0.94), p for trend 0.03). Further adjustment for potential dietary confounders did not materially change the association for K1, while the association for K2 was slightly attenuated (HRQ4vsQ1 = 0.58 (0.28 to 1.19)).

Conclusions: A higher intake of vitamin K2 was associated with lower risk of CHD, while there was no association between intake of vitamin K1 and CHD.

Trial registration number: NCT03013725.

Keywords: cardiac epidemiology; coronary heart disease; nutrition & dietetics.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Cox proportional hazards regression with penalised splines, The Hordaland Health Study. Distribution of partial HR (solid line) with 95% CI (shadow) for coronary heart disease across the distribution of dietary vitamin K2 in μg per day (not energy-adjusted residuals). The model includes adjustment for age, sex, total energy intake, physical activity, smoking habits and education. Intakes above the 95th percentile and below the 5th percentile are excluded in the figure.

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