title: Vitamin K treatment reduces undercarboxylated osteocalcin but does not alter bone turnover, density, or geometry in healthy postmenopausal North American women.
abstract: Low vitamin K status is associated with low BMD and increased fracture risk. Additionally, a specific menaquinone, menatetrenone (MK4), may reduce fracture risk. However, whether vitamin K plays a role in the skeletal health of North American women remains unclear. Moreover, various K vitamers (e.g., phylloquinone and MK4) may have differing skeletal effects. The objective of this study was to evaluate the impact of phylloquinone or MK4 treatment on markers of skeletal turnover and BMD in nonosteoporotic, postmenopausal, North American women. In this double-blind, placebo-controlled study, 381 postmenopausal women received phylloquinone (1 mg daily), MK4 (45 mg daily), or placebo for 12 mo. All participants received daily calcium and vitamin D(3) supplementation. Serum bone-specific alkaline phosphatase (BSALP) and n-telopeptide of type 1 collagen (NTX) were measured at baseline and 1, 3, 6, and 12 mo. Lumbar spine and proximal femur BMD and proximal femur geometry were measured by DXA at baseline and 6 and 12 mo. At baseline, the three treatment groups did not differ in demographics or study endpoints. Compliance with calcium, phylloquinone, and MK4 treatment was 93%, 93%, and 87%, respectively. Phylloquinone and MK4 treatment reduced serum undercarboxylated osteocalcin but did not alter BSALP or NTX. No effect of phylloquinone or MK4 on lumbar spine or proximal femur BMD or proximal femur geometric parameters was observed. This study does not support a role for vitamin K supplementation in osteoporosis prevention among healthy, postmenopausal, North American women receiving calcium and vitamin D supplementation.
authors.affiliation: University of Wisconsin Osteoporosis Clinical Research Program, Madison, Wisconsin 53705, USA. nbinkley@wisc.edu
authors.forename: Neil
authors.initials: N
authors.lastname: Binkley
authors.forename: Judith
authors.initials: J
authors.lastname: Harke
authors.forename: Diane
authors.initials: D
authors.lastname: Krueger
authors.forename: Jean
authors.initials: J
authors.lastname: Engelke
authors.forename: Nellie
authors.initials: N
authors.lastname: Vallarta-Ast
authors.forename: Dessa
authors.initials: D
authors.lastname: Gemar
authors.forename: Mary
authors.initials: M
authors.lastname: Checovich
authors.forename: Richard
authors.initials: R
authors.lastname: Chappell
authors.forename: John
authors.initials: J
authors.lastname: Suttie
mesh_terms: D015502:Absorptiometry, Photon; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015675:Osteocalcin / Q000097:blood*; D010919:Placebos; D017698:Postmenopause; D014812:Vitamin K / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010837:Vitamin K 1 / Q000008:administration & dosage / Q000009:adverse effects; D024482:Vitamin K 2 / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D010919:Placebos; D015675:Osteocalcin; D024482:Vitamin K 2; D014812:Vitamin K; C030814:menatetrenone; D010837:Vitamin K 1; D000469:Alkaline Phosphatase