Associations between Vitamin K Biochemical Measures and Bone Mineral Density in Men and Women

TLDR

Few data exist on the association between vitamin K status and bone mineral density in men and women of varying ages, and the target population—especially estrogen use—may be critical, as suggested by this study. Clinical trials are required to isolate any putative effects of vitamin K on rates of bone loss. The study examined cross‑sectional associations between plasma phylloquinone and percent undercarboxylated osteocalcin and hip and spine bone mineral density in 741 men and 863 women (mean age 59, range 32–86) from the Framingham Heart Study. In men, low plasma phylloquinone and high %ucOC were linked to lower femoral neck BMD, while in postmenopausal women not on estrogen, low plasma phylloquinone was associated with lower spine BMD; no significant associations were observed in premenopausal women or estrogen‑using postmenopausal women.

Abstract

Few data exist on the association between vitamin K status and bone mineral density (BMD) in men and women of varying ages. We examined cross-sectional associations between biochemical measures of vitamin K status and BMD at the hip and spine in 741 men and 863 women (mean age, 59 yr; range, 32–86 yr) who participated in the Framingham Heart Study (1996–2000). Vitamin K status was assessed by plasma phylloquinone and percentage undercarboxylated osteocalcin (%ucOC). Among the men, low plasma phylloquinone concentrations adjusted for triglycerides and elevated serum %ucOC levels were associated with low BMD at the femoral neck (P = 0.03 and 0.009, respectively). Among postmenopausal women not using estrogen replacements, low plasma phylloquinone concentrations were associated with low spine BMD (P = 0.007), with a nonsignificant trend of an elevated serum %ucOC with low spine BMD (P = 0.08). In contrast, there were no significant associations between biochemical measures of vitamin K and BMD in either premenopausal women or postmenopausal women using estrogen replacements. Clinical trials are required to isolate any putative effects of vitamin K on rates of bone loss. The target population in these trials, particularly in regard to estrogen use, may be critical, as suggested by the findings of this study.