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Open AccessArticle

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

Institution of Clinical Science Lund, Medical Faculty, Lund University, S-22185 Lund, Sweden
Department of Biochemistry, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
R&D Group VitaK, Maastricht University, Oxfordlaan 55, 6229 ER Maastricht, The Netherlands
Department of Anaesthesiology and Intensive Care, Institution of Clinical Sciences Lund, Lund University and Skane University Hospital, S-22185 Lund, Sweden
Author to whom correspondence should be addressed.
Nutrients 2018, 10(1), 46;
Received: 15 November 2017 / Revised: 22 December 2017 / Accepted: 2 January 2018 / Published: 5 January 2018
(This article belongs to the Special Issue Vitamin K in Human Health and Disease)
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. View Full-Text
Keywords: atherosclerosis; malnutrition; matrix Gla protein; osteocalcin; surgery; vitamin K atherosclerosis; malnutrition; matrix Gla protein; osteocalcin; surgery; vitamin K
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Dahlberg, S.; Ede, J.; Schurgers, L.; Vermeer, C.; Kander, T.; Klarin, B.; Schött, U. Desphospho-Uncarboxylated Matrix-Gla Protein Is Increased Postoperatively in Cardiovascular Risk Patients. Nutrients 2018, 10, 46.

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