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Desphospho-Uncarboxylated Matrix-Gla Protein Is Increased Postoperatively in Cardiovascular Risk Patients

Dahlberg, Sofia; Ede, Jacob; Schurgers, Leon; Vermeer, Cees; Kander, Thomas LU ; Klarin, Bengt LU and Schött, Ulf LU (2018) In Nutrients 10(1).
Abstract (Swedish)
Abstract: Background: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on
glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphosphouncarboxylated-
MGP, has been associated with increased arterial calcification and stiffness. The aim
of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla
proteins in patients scheduled for abdominal or orthopaedic surgery. Methods: Forty patients
undergoing abdominal or orthopaedic surgery were included. Blood samples were collected
preoperatively and four days after the surgery. Desphospho-carboxylated MGP (dp-cMGP),
desphospho-uncarboxylated MGP (dp-ucMGP), carboxylated osteocalcin... (More)
Abstract: Background: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on
glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphosphouncarboxylated-
MGP, has been associated with increased arterial calcification and stiffness. The aim
of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla
proteins in patients scheduled for abdominal or orthopaedic surgery. Methods: Forty patients
undergoing abdominal or orthopaedic surgery were included. Blood samples were collected
preoperatively and four days after the surgery. Desphospho-carboxylated MGP (dp-cMGP),
desphospho-uncarboxylated MGP (dp-ucMGP), carboxylated osteocalcin (OC) (cOC), uncarboxylated
OC (ucOC), and uncarboxylated prothrombin (PIVKA-II) were analysed. Results: Preoperatively,
29 patients had dp-ucMGP levels above the reference values. Patients with pre-existing cardiovascular
comorbidities had higher dp-ucMGP preoperatively compared with patients with no record of
cardiovascular disease. Postoperatively, this number increased to 36 patients, and median dp-ucMGP
levels increased (p < 0.0001) and correlated to a PIVKA-II increase (r = 0.44). On the other hand,
dp-cMGP levels did not significantly alter. Decreased levels of ucOC and cOC were seen after
surgery (p = 0.017 and p = 0.0033, respectively). Comorbidities, possible nutritional defects, and
complications affecting Gla protein activity and function were identified. Conclusions. Dp-ucMGP
was high preoperatively, and had further increased postoperatively. This pattern was linked to several
comorbidities, possible nutritional defects, and postoperative complications, which motivates further
research about potential interactions between perioperative corrective treatments with vitamin K
supplements, cardiovascular biomarkers, and incidents of stroke and myocardial infarction events. (Less)
Abstract

BACKGROUND: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphospho-uncarboxylated-MGP, has been associated with increased arterial calcification and stiffness. The aim of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla proteins in patients scheduled for abdominal or orthopaedic surgery.

METHODS: Forty patients undergoing abdominal or orthopaedic surgery were included. Blood samples were collected preoperatively and four days after the surgery. Desphospho-carboxylated MGP (dp-cMGP), desphospho-uncarboxylated MGP (dp-ucMGP), carboxylated osteocalcin (OC) (cOC), uncarboxylated OC... (More)

BACKGROUND: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphospho-uncarboxylated-MGP, has been associated with increased arterial calcification and stiffness. The aim of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla proteins in patients scheduled for abdominal or orthopaedic surgery.

METHODS: Forty patients undergoing abdominal or orthopaedic surgery were included. Blood samples were collected preoperatively and four days after the surgery. Desphospho-carboxylated MGP (dp-cMGP), desphospho-uncarboxylated MGP (dp-ucMGP), carboxylated osteocalcin (OC) (cOC), uncarboxylated OC (ucOC), and uncarboxylated prothrombin (PIVKA-II) were analysed.

RESULTS: Preoperatively, 29 patients had dp-ucMGP levels above the reference values. Patients with pre-existing cardiovascular comorbidities had higher dp-ucMGP preoperatively compared with patients with no record of cardiovascular disease. Postoperatively, this number increased to 36 patients, and median dp-ucMGP levels increased (p < 0.0001) and correlated to a PIVKA-II increase (r = 0.44). On the other hand, dp-cMGP levels did not significantly alter. Decreased levels of ucOC and cOC were seen after surgery (p = 0.017 and p = 0.0033, respectively). Comorbidities, possible nutritional defects, and complications affecting Gla protein activity and function were identified.

CONCLUSIONS: Dp-ucMGP was high preoperatively, and had further increased postoperatively. This pattern was linked to several comorbidities, possible nutritional defects, and postoperative complications, which motivates further research about potential interactions between perioperative corrective treatments with vitamin K supplements, cardiovascular biomarkers, and incidents of stroke and myocardial infarction events.

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Contribution to journal
publication status
published
subject
keywords
Journal Article
in
Nutrients
volume
10
issue
1
publisher
MDPI AG
ISSN
2072-6643
DOI
10.3390/nu10010046
language
English
LU publication?
yes
id
4e8eb0cb-dbe5-444c-ab1e-c85cb32dc066
date added to LUP
2018-01-08 12:58:36
date last changed
2018-02-14 16:00:46
@article{4e8eb0cb-dbe5-444c-ab1e-c85cb32dc066,
  abstract     = {<p>BACKGROUND: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphospho-uncarboxylated-MGP, has been associated with increased arterial calcification and stiffness. The aim of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla proteins in patients scheduled for abdominal or orthopaedic surgery.</p><p>METHODS: Forty patients undergoing abdominal or orthopaedic surgery were included. Blood samples were collected preoperatively and four days after the surgery. Desphospho-carboxylated MGP (dp-cMGP), desphospho-uncarboxylated MGP (dp-ucMGP), carboxylated osteocalcin (OC) (cOC), uncarboxylated OC (ucOC), and uncarboxylated prothrombin (PIVKA-II) were analysed.</p><p>RESULTS: Preoperatively, 29 patients had dp-ucMGP levels above the reference values. Patients with pre-existing cardiovascular comorbidities had higher dp-ucMGP preoperatively compared with patients with no record of cardiovascular disease. Postoperatively, this number increased to 36 patients, and median dp-ucMGP levels increased (p &lt; 0.0001) and correlated to a PIVKA-II increase (r = 0.44). On the other hand, dp-cMGP levels did not significantly alter. Decreased levels of ucOC and cOC were seen after surgery (p = 0.017 and p = 0.0033, respectively). Comorbidities, possible nutritional defects, and complications affecting Gla protein activity and function were identified.</p><p>CONCLUSIONS: Dp-ucMGP was high preoperatively, and had further increased postoperatively. This pattern was linked to several comorbidities, possible nutritional defects, and postoperative complications, which motivates further research about potential interactions between perioperative corrective treatments with vitamin K supplements, cardiovascular biomarkers, and incidents of stroke and myocardial infarction events.</p>},
  articleno    = {46},
  author       = {Dahlberg, Sofia and Ede, Jacob and Schurgers, Leon and Vermeer, Cees and Kander, Thomas and Klarin, Bengt and Schött, Ulf},
  issn         = {2072-6643},
  keyword      = {Journal Article},
  language     = {eng},
  month        = {01},
  number       = {1},
  publisher    = {MDPI AG},
  series       = {Nutrients},
  title        = {Desphospho-Uncarboxylated Matrix-Gla Protein Is Increased Postoperatively in Cardiovascular Risk Patients},
  url          = {http://dx.doi.org/10.3390/nu10010046},
  volume       = {10},
  year         = {2018},
}