High dephospho-uncarboxylated matrix Gla protein concentrations, a plasma biomarker of vitamin K, in relation to frailty: the Longitudinal Aging Study Amsterdam (Machado‑Fragua MD et al.)
European Journal of Nutrition has published results of a prospective cohort study whose authors assessed the relationship between vitamin K status and frailty over 13 years in the Longitudinal Aging Study Amsterdam (LASA), and found that higher concentrations of desphospho-uncarboxylated matrix Gla protein (dp-ucMGP), which correspond with a lower vitamin K status, were associated with a higher frailty index score.
Frailty is a state of greater vulnerability to external stressors, caused by the loss of abilities in multiple domains of functioning. It is a reversible state and has been linked to various adverse health outcomes, such as falls, disability, hospitalization and death. Since the relationship between vitamin K status and frailty has not been investigated to date, a group of researchers used data from the Longitudinal Aging Study Amsterdam (LASA) to examine the prospective association between vitamin K status and frailty in older adults over 13 years of follow-up. A cohort of 644 community-dwelling adults ≥ 55 years was recruited from the LASA participants for the purpose of this study. In 2002–2003, plasma dp-ucMGP was measured as marker of vitamin K status through a sandwich (dual antibody) ELISA. Frailty was measured at baseline and in four follow-up examinations with the LASA Frailty Index (LASAFI), which was used as both a continuous and a dichotomous measure (FI ≥ 0.25), as indicator of the degree of frailty and frailty risk, respectively. Statistical analyses were performed with multivariable generalized estimating equations using the lowest dp-ucMGP tertile, reflecting a high vitamin K status, as reference. Of the 644 participants in the study, the mean (SD) age was 59.9 (2.9) years, and 54% were female. Compared with the lowest tertile, the medium and highest dp-ucMGP tertile were associated with a higher degree of frailty [1.40, 95% confidence interval (0.01–2.81) and 1.62, (0.18–3.06), respectively. P trend: 0.03]. Additionally, the medium and highest dp-ucMGP tertile had a higher odds ratio of frailty [1.75 (1.11–2.77) and 1.63 (1.04–2.57), respectively]. The degree of frailty increased over time, but the differences by dp-ucMGP tertiles existed since baseline and remained stable during follow-up.
The authors noticed that baseline plasma low vitamin K status was associated with a greater degree of frailty and frailty risk in this cohort of older adults. “This highlights the importance of ensuring adequate nutritional status of this vitamin in older adults to reach optimal levels by promoting the consumption of foods rich in vitamin K, such as green leafy vegetables and fermented dairy products, which could slow down the development of frailty in this population,” they concluded.
“Researchers believe that it is of major importance to know the factors that influence frailty, to be able to develop public health strategies aimed at reducing or preventing frailty,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. “In a previous analysis in the LASA cohort,2 low vitamin K status was associated with lower handgrip strength, smaller calf circumference, and, in women only, with poorer functional performance score. Moreover, if we look at table 1 in the presently discussed paper, we will notice that low vitamin K status (represented by highest dp-ucMGP) increases the risk of hypertension, type 2 diabetes and a number of chronic diseases. These facts articulate the usefulness of vitamin K2 supplementation for preventing frailty in the elderly population,” she points out.
- Machado-Fragua MD, Hoogendijk EO, Struijk EA, et al. High dephospho-uncarboxylated matrix Gla protein concentrations, a plasma biomarker of vitamin K, in relation to frailty: the Longitudinal Aging Study Amsterdam. Eur J Nutr. 2020;59(3):1243‐1251. doi:10.1007/s00394-019-01984-9
- van Ballegooijen AJ, van Putten SR, Visser M, Beulens JW, Hoogendijk EO. Vitamin K status and physical decline in older adults-The Longitudinal Aging Study Amsterdam. Maturitas. 2018;113:73‐79. doi:10.1016/j.maturitas.2018.04.013