Vitamin K: Genetics of Vascular Calcification

冠状动脉和主动脉的血管钙化是冠心病（CHD）和其他心血管疾病（CVD）的危险因素。此外，血管钙化也与骨质疏松症有关。心血管疾病和骨质疏松症都是与年龄相关的主要健康问题，随着全球人口老龄化的持续，它们的影响将越来越重要。相当大比例的冠心病风险是由可改变的冠状动脉危险因素引起的，如高血压、高脂血症和吸烟。这些知识已被用于实施成功的预防和治疗策略，以阻止世纪后期发生的CHD死亡率增加。同样，识别那些导致老年人群血管钙化增加和骨量减少的可改变因素，可能会导致额外的有效干预措施，以减少老年人的骨质疏松。 不仅是CHD的负担，而且是一般人群中骨折的负担。从预防的角度来看，确定这两种疾病共同的饮食风险因素尤为重要，因为饮食治疗的成本相对较低且安全。本研究的主要目的是确定维生素K代谢，骨质疏松症和血管钙化的遗传成分，以及老年男性和女性对膳食补充剂的反应的变异性。为此，我们将在450名参加NIH资助的III期临床研究的老年受试者中评估某些候选基因[载脂蛋白E（APOE）、脂蛋白脂酶（LPL）、基质玻璃蛋白（MGP）、维生素D受体（VDR）]的单核苷酸多态性（SNP）和单倍型与维生素K代谢相关指标、骨质疏松症和血管钙化的基线水平之间的关联。此外，我们将通过以下方式分析基因： 处理相互作用，以确定所检查的基因对响应于维生素补充的变异性的贡献。据我们所知，这是第一个研究遗传变异对维生素K补充、年龄相关性骨质流失和血管钙化进展的影响的提案。这项研究应该为更全面的遗传研究提供基础，旨在更好地识别这些年龄相关的风险和更精确的治疗方法。 紊乱

Vascular calcification of the coronary arteries and aorta is a risk factor for coronary heart disease (CHD) and other cardiovascular diseases (CVD). In addition, vascular calcification has also been associated with osteoporosis. Both CVD and osteoporosis represent major age-associated health problems and their impact will increase in importance as the global aging of the population continues. A substantial proportion of CHD risk results from modifiable coronary risk factors, such as hypertension, hyperlipidemia, and cigarette smoking. This knowledge has been used to implement successful prevention and therapeutic strategies to stop the increase in CHD mortality that took place during the latter part of the 20th Century. Likewise, identification of those modifiable factors that contribute to an increase in vascular calcification and a reduction in bone mass in older populations could lead to additional effective interventions to reduce the burden not only for CHD but also for fractures in the general population. From the standpoint of prevention, the identification of dietary risk factors common to both diseases is particularly important, because the relatively low cost and safety of dietary therapy. The primary objectives of this study are to identify genetic components underlying vitamin K metabolism, osteoporosis, and vascular calcification and the variability in response to dietary supplementation in elderly men and women. For this purpose, we will evaluate associations between single nucleotide polymorphisms (SNPs) and haplotypes at certain candidate genes [apolipoprotein E (APOE), lipoprotein lipase (LPL), Matrix Gla Protein (MGP), Vitamin D Receptor (VDR)] and baseline levels of vitamin K metabolism related measures, osteoporosis, and vascular calcification in 450 elderly subjects participating in a NIH funded phase III clinical study. Moreover, we will analyze gene by treatment interactions in order to determine the contribution of the genes examined to the variability in response to vitamin supplementation. To the best of our knowledge, this is the first proposal of its kind to study the influence of genetic variation in response to vitamin K supplementation, progression of age-related bone loss and vascular calcification. This research should provide the basis for more comprehensive genetic studies aimed to provide better identification of risk and more precise therapeutic approaches for these age-related disorders.