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Chronic kidney diseases (CKD) are often associated with vascular calcification, which results in a significantly increased risk of cardiovascular diseases for CKD patients.
Matrix γ-carboxyglutamatic acid (Gla) protein, or matrix Gla protein (MGP) for short, is the most well-known inhibitor of vascular and tissue calcification. It is a protein synthesised in smooth-muscle cells, endothelial cells and chondrocytes, which can enter the vessel wall due to its small size. Activated MGP can bind free calcium locally and thus prevent its accumulation in vessels and tissue. Vitamin K2 is an essential co-factor in the activation of MGP by γ-carboxylation.
An insufficient vitamin K2 supply causes an increase in inactive MGP, also called dephosphorylated-uncarboxylated MGP (dp-ucMGP). Dp-ucMGP cannot prevent vascular calcification. Increased dp-ucMPG levels are thus considered a risk marker for cardiovascular diseases.
Since a high dp-ucMGP concentration in plasma may be caused by an insufficient vitamin K2 supply, dp-ucMGP is also a significant marker with regard to the vitamin K2 status.
The dp-ucMGP concentration allows to draw conclusions on the physiological state of the vessels and thus functions as an important diagnostic predictor of negative cardiovascular consequences and mortality. Regular monitoring of the dp-ucMGP level is particularly recommended in elderly people who are prone to atherosclerosis as well as CKD patients to assess the risk of vascular complications.
Furthermore, the measurement of dp-ucMGP provides essential information on the vitamin K status as the dp-ucMGP concentration correlates directly with vitamin K availability in the body, which sets it apart from classic methods such as direct measurement of vitamin K in plasma, which are but a snapshot and give little information on vitamin K distribution in the tissues.
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