Related Experiment Video

Updated: May 9, 2026

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

Matrix Gla protein species and risk of cardiovascular events in type 2 diabetic patients

Geertje W Dalmeijer1, Yvonne T van der Schouw, Elke J Magdeleyns

  • 1Corresponding author: Geertje W. Dalmeijer, g.w.dalmeijer@umcutrecht.nl.

Diabetes Care
|July 24, 2013
PubMed

Insights

Higher levels of desphospho-uncarboxylated matrix Gla protein (dp-ucMGP) are linked to increased cardiovascular disease (CVD) risk in type 2 diabetes patients, particularly peripheral arterial disease and heart failure. This suggests a potential role for vitamin K status in CVD risk.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Nutritional Science

Background:

  • Type 2 diabetes is a significant risk factor for cardiovascular disease (CVD).
  • Matrix Gla protein (MGP) is a vitamin K-dependent protein involved in vascular calcification.
  • Specific circulating MGP species may serve as biomarkers for CVD risk in diabetic populations.

Purpose of the Study:

  • To examine the association between different circulating matrix Gla protein (MGP) species and the incidence of cardiovascular disease (CVD) and its subtypes in individuals with type 2 diabetes.
  • To determine if specific MGP forms are predictive of CVD events in this high-risk cohort.

Main Methods:

  • Prospective cohort study (EPIC-NL) of 40,011 participants, with 518 individuals with type 2 diabetes at baseline.
  • Measurement of circulating MGP species (dp-ucMGP, dp-MGP, total-ucMGP) using ELISA in baseline plasma samples.
  • Incident CVD and subtypes (CHD, PAD, heart failure, stroke) ascertained through national register linkage, analyzed using Cox proportional hazard models.

Main Results:

  • Higher levels of circulating desphospho-uncarboxylated MGP (dp-ucMGP) were significantly associated with an increased risk of overall CVD (HRSD 1.21), peripheral arterial disease (PAD) (HRSD 1.32), and heart failure (HRSD 1.75).
  • No significant association was found between higher dp-ucMGP levels and the risk of coronary heart disease (CHD) or stroke.
  • Circulating desphospho-carboxylated MGP and total-uncarboxylated MGP levels were not associated with CVD or its subtypes.

Conclusions:

  • Elevated circulating dp-ucMGP levels are a significant risk factor for incident CVD in type 2 diabetic patients, particularly for PAD and heart failure.
  • Other measured MGP species (dp-MGP, total-ucMGP) did not show a relationship with CVD risk.
  • These findings suggest that poor vitamin K status, indicated by high dp-ucMGP, may contribute to increased CVD risk in type 2 diabetes.
Abstract

More Related Videos

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model06:22

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model

Published on: November 29, 2024

Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...