title: Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women.
abstract: BACKGROUND
  Vitamin K has been associated with bone mineral density (BMD) and risk of hip fracture. The apolipoprotein (apo) E4 allele (APOE*E4) has been associated with bone fracture through a putative effect on vitamin K transport in blood.
  
  
  OBJECTIVE
  The objective was to determine the associations between vitamin K intake, apo E genotype, BMD, and hip fracture in a population-based cohort of elderly men and women.
  
  
  METHODS
  Dietary vitamin K intake was assessed with a food-frequency questionnaire in 335 men and 553 women (average age: 75.2 y) participating in the Framingham Heart Study in 1988-1989. Incidence of hip fractures was recorded from 1988 to 1995. BMD at the hip, spine, and arm was assessed on 2 separate occasions (1988-1989 and 1992-1993). Comparisons between apo E genotype and BMD were made relative to E4 allele status (at least 1 epsilon4 allele compared with no epsilon4 allele).
  
  
  RESULTS
  Individuals in the highest quartile of vitamin K intake (median: 254 microg/d) had a significantly lower fully adjusted relative risk (0.35; 95% CI: 0. 13, 0.94) of hip fracture than did those in the lowest quartile of intake (median: 56 microg/d). There were no associations between vitamin K intake and BMD in either men or women. No association was found between the E4 allele and BMD, and there were no significant interactions between the E4 allele and phylloquinone intake and BMD or hip fracture.
  
  
  CONCLUSIONS
  Low vitamin K intakes were associated with an increased incidence of hip fractures in this cohort of elderly men and women. Neither low vitamin K intake nor E4 allele status was associated with low BMD.
authors.affiliation: Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, USA. sbooth@hnrc.tufts.edu
authors.forename: S L
authors.initials: SL
authors.lastname: Booth
authors.forename: K L
authors.initials: KL
authors.lastname: Tucker
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: M T
authors.initials: MT
authors.lastname: Hannan
authors.forename: D R
authors.initials: DR
authors.lastname: Gagnon
authors.forename: L A
authors.initials: LA
authors.lastname: Cupples
authors.forename: P W
authors.initials: PW
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: Ordovas
authors.forename: E J
authors.initials: EJ
authors.lastname: Schaefer
authors.forename: B
authors.initials: B
authors.lastname: Dawson-Hughes
authors.forename: D P
authors.initials: DP
authors.lastname: Kiel
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D015331:Cohort Studies; D004247:DNA / Q000737:chemistry / Q000302:isolation & purification; D019587:Dietary Supplements; D004435:Eating; D004591:Electrophoresis, Polyacrylamide Gel; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D016133:Polymerase Chain Reaction; D011795:Surveys and Questionnaires; D014812:Vitamin K / Q000008:administration & dosage / Q000502:physiology*; D014813:Vitamin K Deficiency / Q000503:physiopathology*
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D014812:Vitamin K; D004247:DNA