{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:14:40Z","timestamp":1780535680684,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2018,5,17]],"date-time":"2018-05-17T00:00:00Z","timestamp":1526515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL-121510-01A1"],"award-info":[{"award-number":["R01 HL-121510-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R56 HL-124073-01A"],"award-info":[{"award-number":["R56 HL-124073-01A"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Large artery stiffening is increased in advanced chronic kidney disease (CKD) but likely develops progressively in earlier stages of CKD. Active matrix Gla-protein (MGP) is a potent vitamin K\u2013dependent inhibitor of vascular calcification. A recent animal model demonstrated intrinsic abnormalities in vitamin K metabolism even in early CKD, but whether early human CKD is associated with vascular vitamin K deficiency is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We enrolled 137 adults without HF with varying degrees of renal function: normal estimated glomerular filtration rate (eGFR; &amp;gt;90 ml\/min; n = 59), mildly reduced eGFR (stage 2 CKD: eGFR = 60\u201389 ml\/min; n = 53) or at least moderately reduced eGFR (stage 3\u20135 CKD; eGFR &amp;lt; 60 ml\/min; n = 25). Carotid-femoral pulse wave velocity (CF-PWV) was measured with carotid and femoral tonometry. Dephospho-uncarboxylated matrix gla-protein (dp-ucMGP) was measured with enzyme-linked immunosorbent assay (ELISA) (VitaK; Maastricht University; The Netherlands).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULT<\/jats:title>\n                  <jats:p>Dp-ucMGP levels were progressively increased with decreasing renal function (eGFR \u2265 90: 247 pmol\/l; eGFR 60\u201389: 488 pmol\/l; eGFR &amp;lt; 60: 953 pmol\/l; P &amp;lt; 0.0001). These differences persisted after adjustment for multiple potential confounders (eGFR \u2265 90: 314 pmol\/l; eGFR 60\u201389: 414 pmol\/l; eGFR &amp;lt; 60: 770 pmol\/l; P &amp;lt; 0.0001). In a multivariable model adjusted for various confounders, dp-ucMGP was a significant independent predictor of CF-PWV (\u03b2 = 0.21; P = 0.019). In formal mediation analyses, dp-ucMGP mediated a significant relationship between eGFR and higher CF-PWV (\u03b2 = \u22120.16; P = 0.005), whereas no significant dp-ucMGP\u2013independent relationship was present (\u03b2 = \u22120.02; P = 0.80).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>CKD is associated with increased (inactive) dp-ucMGP, a vitamin K\u2013dependent inhibitor of vascular calcification, which correlates with large artery stiffness. Further studies are needed to assess whether vitamin K2 supplementation represents a suitable therapeutic strategy to prevent or reduce arterial stiffening in CKD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpy079","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T08:43:31Z","timestamp":1525941811000},"page":"988-994","source":"Crossref","is-referenced-by-count":63,"title":["Circulating Dephospho-Uncarboxylated Matrix Gla-Protein Is Associated With Kidney Dysfunction and Arterial Stiffness"],"prefix":"10.1093","volume":"31","author":[{"given":"Houry","family":"Puzantian","sequence":"first","affiliation":[{"name":"Department of Biobehavioral Health Science, University of Illinois, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R","family":"Akers","sequence":"additional","affiliation":[{"name":"Department of Medicine and Radiology, Corporal Michael J. 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