Tsugawa Naoko, Shiraki Masataka, Suhara Yoshitomo, Kamao Maya, Ozaki Reo, Tanaka Kiyoshi, Okano Toshio
Department of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe 658-8558, Japan.
J Bone Miner Metab. 2008;26(1):79-85. doi: 10.1007/s00774-007-0790-8. Epub 2008 Jan 10.
It has been reported that vitamin K supplementation effectively prevents fractures and sustains bone mineral density in osteoporosis. However, there are only limited reported data concerning the association between vitamin K nutritional status and bone mineral density (BMD) or fractures in Japan. The objectives were to evaluate the association between plasma phylloquinone (K1) or menaquinone (MK-4 and MK-7) concentration and BMD or fracture in Japanese women prospectively. A total of 379 healthy women aged 30-88 years (mean age, 63.0 years) were consecutively enrolled. Plasma K1, MK-4, MK-7, and serum undercarboxylated osteocalcin (ucOC) concentrations, BMD, and incidence of vertebral fractures were evaluated. In stepwise multiple linear regression analyses, L2-4 BMD and a bone turnover marker, log K1, concentrations were independently correlated with vertebral fracture incidence. When subjects were divided into low and high K1 groups by plasma K1 concentration, the incidence of vertebral fracture in the low K1 group (14.4%) was significantly higher than that in the high K1 group (4.2%), and its age-adjusted RR was 3.58 (95% CI, 3.26-3.93). L2-4 BMD was not different between the two groups. These results suggest that subjects with vitamin K1 insufficiency in bone have increased susceptibility for vertebral fracture independently from BMD.
据报道，补充维生素K可有效预防骨质疏松症患者的骨折并维持骨矿物质密度。然而，在日本，关于维生素K营养状况与骨矿物质密度（BMD）或骨折之间关联的报道数据有限。目的是前瞻性评估日本女性血浆叶绿醌（K1）或甲基萘醌（MK - 4和MK - 7）浓度与BMD或骨折之间的关联。共有379名年龄在30 - 88岁（平均年龄63.0岁）的健康女性连续入选。评估了血浆K1、MK - 4、MK - 7、血清未羧化骨钙素（ucOC）浓度、BMD和椎体骨折发生率。在逐步多元线性回归分析中，L2 - 4 BMD和一种骨转换标志物——log K1浓度与椎体骨折发生率独立相关。当根据血浆K1浓度将受试者分为低K1组和高K1组时，低K1组的椎体骨折发生率（14.4%）显著高于高K1组（4.2%），其年龄调整后的RR为3.58（95% CI，3.26 - 3.93）。两组之间的L2 - 4 BMD无差异。这些结果表明，骨骼中维生素K1不足的受试者独立于BMD，发生椎体骨折的易感性增加。
