Vitamin K And Vascular Calcification: A Systematic Review And Meta-analysis Of Randomized Controlled Trials

Background:Vascular calcification(VC)is a complex process that has been linked to conditions including cardiovascular diseases and chronic kidney disease.There is ongoing debate about whether vitamin K(VK)can effectively prevent VC.To assess the efficiency and safety of VK supplementation in the therapies of VC,we performed a systematic review and meta-analysis of recent studies.Methods:Using Cochrane systematic review methods,we searched Pub Med,Cochrane Library,Embase database,and Web of science in four English databases up until August 2022.14 randomized controlled trials(RCTs)describing the outcomes of treatment for VK supplementation with VC have been included out of 332 studies.Results were reported in the coronary artery calcification(CAC)score and other arterial calcification,vascular stiffness,carotid intima-media thickness changes,desphospho-uncarboxylated matrix Gla protein(dp-uc MGP),laboratory indicators and hemodynamic parameters.Similarly,serious adverse events have been reported.Results:We reviewed 14 RCTs,comprising a total of 1533 patients.Overall,the risk of bias is moderate.It was found that supplementation of VK reduced carotid-radial pulse velocity to some extent(I~2=26%,MD=-0.42,95%CI[-0.08,-0.05],p=0.03),but there was no significant change in carotid-femoral pulse velocity.Our analysis revealed that VK supplementation has a significant effect on CAC scores,slowing down the progression of CAC(I~2=34%,MD=–17.37,95%CI[–34.18,–0.56],p=0.04).Moreover,the study found that VK supplementation had a significant impact on dp-uc MGP levels,as compared to the control group,where those receiving VK supplementation had lower values(I~2=71%,MD=–243.31,95%CI[–366.08,–120.53],p=0.0001).Additionally,there was no significant difference in the adverse events between the groups(I~2=31%,RR=0.92,95%CI[–0.79,1.07],p=0.29).Furthermore,hemodynamic and laboratory-related indexes were not affected by VK supplementation.Conclusions:VK has good therapeutic potential for VC,atherosclerosis or arteriosclerosis.However,more rigorously designed RCTs are needed in the future to verify the benefits and efficacy of VK in the treatment of VC.