title: Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease.
abstract: Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (vitamin K1). By conducting two RCT, the present study aimed to first establish whether supplementation with 1000 μg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum (%ucOC; marker of vitamin K status) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass. The initial dose-ranging RCT was conducted in adult patients with CD (n 10 per group) using 0 (placebo), 1000 or 2000 μg of phylloquinone daily for 2 weeks. In the main RCT, the effect of placebo v. 1000 μg vitamin K/d (both co-administered with Ca (500 mg/d) and vitamin D3 (10 μg/d)) for 12 months (n 43 per group) on the biochemical indices of bone turnover (determined by enzyme immunoassay) and bone mass (determined by dual-energy X-ray absorptiometry) were investigated. At baseline, the mean %ucOC was 47 %, and this was suppressed upon supplementation with 1000 μg of phylloquinone daily ( - 81 %; P< 0·01) and not suppressed further by 2000 μg of phylloquinone daily. Compared with the placebo, supplementation with 1000 μg of phylloquinone daily for 12 months had no significant effect (P>0·1) on bone turnover markers or on the bone mass of the lumbar spine or femur, but modestly increased (P< 0·05) the bone mass of the total radius. Despite near maximal suppression of serum %ucOC, supplementation with 1000 μg of phylloquinone daily (with Ca and vitamin D3) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency.
authors.affiliation: School of Food and Nutritional Sciences, University College Cork,Cork,Republic of Ireland.
authors.forename: Eibhlís M
authors.initials: EM
authors.lastname: O'Connor
authors.affiliation: Department of Medicine,University College Cork,Cork,Republic of Ireland.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Grealy
authors.affiliation: Department of Medicine,University College Cork,Cork,Republic of Ireland.
authors.forename: Jane
authors.initials: J
authors.lastname: McCarthy
authors.affiliation: Department of Medicine,University College Cork,Cork,Republic of Ireland.
authors.forename: Alan
authors.initials: A
authors.lastname: Desmond
authors.affiliation: Department of Medicine,University College Cork,Cork,Republic of Ireland.
authors.forename: Orla
authors.initials: O
authors.lastname: Craig
authors.affiliation: Department of Medicine,University College Cork,Cork,Republic of Ireland.
authors.forename: Fergus
authors.initials: F
authors.lastname: Shanahan
authors.affiliation: School of Food and Nutritional Sciences, University College Cork,Cork,Republic of Ireland.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Cashman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015519:Bone Density; D016723:Bone Remodeling; D002118:Calcium / Q000008:administration & dosage; D002762:Cholecalciferol / Q000008:administration & dosage; D003424:Crohn Disease / Q000188:drug therapy* / Q000503:physiopathology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010919:Placebos; D014812:Vitamin K; D010837:Vitamin K 1 / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D010919:Placebos; D014815:Vitamins; D014812:Vitamin K; D002762:Cholecalciferol; D010837:Vitamin K 1; D002118:Calcium