Vitamin K status and inflammation are associated with cognition in older Irish adults

Figures & data

Table 1 Classification of ELDERMET subjects into groups based on MMSE number.

MMSE category	Interpretation	Cognitive class
1	MMSE ≤15	Severe cognitive impairment
2	MMSE 16–19	Moderate cognitive impairment
3	MMSE 20–25	Mild cognitive impairment
4	MMSE 26–30	Good/normal cognition

Table 2 Descriptive data presented as mean, standard deviation or median, interquartile range as appropriate or number (percentage)

	Valid N	Descriptive statistics
Gender (% female)	156	100 (64.1%)
Age (years)	154	78.27 (8.54)
BMI (kg/m^2)	156	26.09 (5.81)
Diastolic BP (mmHg)	154	73.38 (11.90)
Systolic BP (mmHg)	154	134.12 (20.48)
Cholesterol (mmol/l)	154	4.91 (1.14)
Triglycerides (mmol/l)	154	1.37 (1.04, 1.86)
CCI	118	1 (0, 2)
MMSE categories	156
1		39 (25%)
2		10 (6.4%)
3		43 (27.6%)
4		64 (41%)
Serum phylloquinone (nmol/l)	153	0.55 (0.33, 1.12)
Dietary phylloquinone (μg/d)	135	90 (65, 149)
% ucOC	156	34.14 (23.52, 46.21)
IL-6 (IU)	153	7.99 (4.84, 13.10)
IL-8 (IU)	153	16.86 (9.84, 26.75)
IL-10 (IU)	153	5.12 (3.27, 10.00)
TNFα (IU)	153	5.23 (3.93, 7.76)
hsCRP (mg/l)	156	34.64 (13.46, 96.40)

Notes: BMI, Body Mass Index, BP, blood pressure, CCI, Charlson Co-Morbidity Index: Score out of a total of 22, higher scores indicate more co-morbidity, MMSE, Mini Mental State Exam; category 1 MMSE <15 = severe cognitive impairment, category 2 MMSE 16–20 = moderate cognitive impairment, category 3 MMSE 21–25 = mild cognitive impairment, category 4 MMSE >26 = normal cognitive function, % ucOC, percentage undercarboxylated osteocalcin, IL-6, interleukin-6, IL-8, interleukin-8, IL-10, interleukin-10, TNFα, Tumour Necrosis Factor α, hsCRP, high sensitivity C-Reactive Protein.

Table 3 Between-group comparisons using one way ANOVA or Kruskal Wallis test

	MMSE category
	1	2	3	4	P-value
Gender (% female)	30 (76.9%)	7 (70%)	25 (58.1%)	38 (59.4%)	.238
Age (years)	84.13 (7.56)	85.70 (8.49)	79.66 (6.60)	72.64 (6.43)	<.001
BMI (kg/m^2)	23.06 (5.04)	20.80 (3.45)	26.90 (5.31)	28.21 (5.67)	<.001
Diastolic BP (mmHg)	69.64 (9.70)	62.56 (16.02)	73.31 (13.39)	77.23 (9.86)	<.001
Systolic BP (mmHg)	125.36 (16.64)	118.89 (16.41)	133.40 (23.82)	142.06 (17.41)	<.001
Cholesterol (mmol/l)	4.81 (1.04)	4.71 (1.46)	4.92 (1.19)	5.00 (1.13)	.819
Triglycerides (mmol/l)	1.37 (1.08, 2.48)	1.48 (1.07, 1.92)	1.48 (1.04, 1.99)	1.27 (0.92, 1.65)	.189^1
CCI	3 (1,4)	3(0, 4)	2 (0, 3)	0 (0, 1)	<.001^1

Notes: Descriptive data presented as mean (SD), median (25th percentile, 75th percentile) or number (%).

BMI (Body Mass Index), BP (blood pressure), CCI, Charlson Co-morbidity Index: Score out of a total of 22, higher scores indicate more co-morbidity.

¹Kruskal–Wallis test.

Table 4 Analysis of covariance (ANCOVA) of differences across Mini Mental State Exam (MMSE) categories

	MMSE category
	1	2	3	4	P-value^1,2
Serum phylloquinone (nmol/l)	0.34 (0.25, 0.61)	0.54 (0.33, 1.05)	0.49 (0.24, 1.12)	0.77 (0.46, 1.31)	.049
Dietary phylloquinone (µg/d)	75.50 (55.00, 94.50)	71.50 (44.00, 86.00)	91.00 (61.00, 151.00)	136.50 (78.00, 252.00)	.002^a,b,c
%ucOC	39.89 (21.41)	38.13 (20.19)	41.08 (22.16)	31.68 (13.83)	.060
IL-6 (IU)	13.33 (8.49, 34.83)	12.10 (5.93, 18.27)	8.06 (4.67, 10.00)	5.41 (3.75, 8.25)	.001^a,b
IL-8 (IU)	27.12 (17.96, 36.00)	22.29 (5.22, 29.36)	16.98 (11.80, 28.83)	13.32 (7.85, 18.82)	.094
IL-10 (IU)	7.00 (4.61, 13.00)	7.29 (5.35, 17.57)	4.72 (2.88, 10.50)	4.01 (2.92, 6.17)	.198
TNFα (IU)	7.76 (6.00, 9.75)	7.11 (4.90, 10.17)	4.38 (3.85, 6.00)	4.56 (3.47, 6.27)	.039
hsCRP (mg/l)	57.39 (32.10, 154.24)	78.34 (47.40, 186.08)	42.39 (15.50, 154.86)	19.62 (8.53, 39.81)	.015^c

Notes: Descriptive data presented as median (25th percentile, 75th percentile) or mean (SD).

¹ANCOVA controlling for sex, age, BMI, triglycerides and blood pressure, ²Serum phylloquinone, dietary phylloquinone, IL-6, IL-8, IL-10, TNFα and hsCRP were transformed to normality using the natural logarithm. Significant post-hoc Bonferroni adjusted pairwise comparisons: ^agroups 1 and 4, ^bgroups 1 and 3, ^cgroups 2 and 4, ^dgroups 3 and 4.

% ucOC, percentage undercarboxylated osteocalcin, IL-6, interleukin-6, IL-8, interleukin-8, IL-10, interleukin-10, TNFα, Tumour Necrosis Factor α, hsCRP, High sensitivity C-Reactive Protein.

Table 5 Partial correlations controlling for sex, age, BMI, triglycerides and blood pressure

	Serum phylloquinone	Dietary phylloquinone	%ucOC	IL-6	IL-8	IL-10	TNFα	hsCRP
Serum phylloquinone	1.000
Dietary phylloquinone	.253**	1.000
%ucOC	−.169	−.046	1.000
IL-6	−.203*	−.263**	.057	1.000
IL-8	-.118	−.161	.200*	.036	1.000
IL-10	−.106	−.090	.094	.453**	.281**	1.000
TNFα	−.187*	−.120	.056	.314**	.389**	.394**	1.000
hsCRP	−.146	−.099	.037	.411**	.074	.151	.067	1.000

Note: Partial correlations controlling for sex, age, BMI, triglycerides and blood pressure (serum phylloquinone, dietary phylloquinone, IL-6, IL-8, IL-10 and TNFα were transformed using the natural logarithm).

BMI, Body Mass Index, % ucOC, percentage uncarboxylated osteocalcin, IL-6, interleukin-6, IL-8, interleukin-8, IL-10, interleukin-10, TNFα, Tumour Necrosis Factor α, hsCRP, high sensitivity C-Reactive Protein.

*P < .05, **P < .01.

Figure 1 Tertiles of dietary phylloquinone (µg/d) versus Mini Mental State Exam (MMSE) grouping.

Figure 2 Tertiles of serum phylloquinone (nmol/ml) versus Mini State Exam (MMSE) grouping.

Table 6 Logistic regression analysis of the association between Good Cognition (MMSE ≥ 26) and Dietary and Serum Phylloquinone Tertiles

		Model 1		Model 2		Model 3
		OR (95% CI)	P-value	OR(95% CI)	P/-value	OR (95% CI)	P-value
Dietary	1st	1	<.001	1	.038	1	.118
Phylloquinone	2nd	1.42 (0.55, 3.69)		1.01 (0.311, 3.68)		1.77 (0.43, 7.29)
Tertiles	3rd	5.25 (2.09, 13.20)		4.03 (1.19, 13.65)		4.07 (1.05, 15.81)
Sex	Male			1	.866		.347
	Female			1.09 (0.39, 3.04)		0.79 (0.30, 2.14)
Age				0.82 (0.76, 0.89)	<.001	0.83 (0.76, 0.91)	<.001
BMI				1.08 (0.98,1.19)	.107	1.13 (1.01, 1.27)	.041
Diastolic BP				1.03 (0.99, 1.08)	.148	1.04 (0.99, 1.10)	.152
Triglycerides				0.34 (0.079, 1.502)	.156	0.27 (0.04, 1.96)	.195
TNFα						3.81 (1.17, 12.39)	.026
IL-6						0.39 (0.17, 0.90)	.028
hsCRP						0.55 (0.32, 0.96)	.034
Serum	st	1	<.001	1	.022	1	.057
Phylloquinone	2nd	4.56 (1.85, 11.24)		4.24 (1.31, 13.68)		3.84 (1.07, 13.74)
Tertiles	3rd	6.01 (2.42, 14.91)		5.15 (1.49, 17.76)		4.75 (1.23, 18.37)
Sex	Male			1	.991	1	.647
	Female			1.01 (0.41, 2.47)		1.26 (0.47, 3.39)
Age				0.85 (0.79, 0.92)	<.001	0.85, (0.78, 0.93)	<.001
BMI				1.09 (0.99, 1.19)	.074	1.12 (1.01, 1.24)	.035
Diastolic BP				1.03 (0.99, 1.07)	.150	1.02 (0.98, 1.07)	.358
Triglycerides				0.10 (0.02, 0.48)	.004	0.08 (0.01, 0.53)	.009
TNFα						3.11 (1.13, 8.57)	.029
IL-6						0.45 (0.22, 0.95)	.037
hsCRP						0.69 (0.44, 1.07)	.098

Model 2: Controlling for sex, age, BMI, Diastolic BP and Triglycerides.

Model 3: Controlling for sex, age, BMI, Diastolic BP, Triglycerides, TNFα, IL-6 and hsCRP.