Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Cheras, Malaysia.
Newcastle University Medicine Malaysia, Jalan Sarjana 1, Educity, 79200, Iskandar Puteri, Malaysia.
Drugs Aging. 2022 Jul;39(7):487-504. doi: 10.1007/s40266-022-00945-y. Epub 2022 May 30.
Vitamin K is essential for the carboxylation of the vitamin K-dependent proteins that are responsible for the suppression of matrix calcification. The use of vitamin K antagonists (VKAs) in patients with cardiovascular diseases could affect protein carboxylation and lead to the development of osteoarthritis (OA). This review aims to summarise the current evidence for the relationship between VKAs and OA. The literature search revealed that in observation studies, good vitamin K status, as reflected by the circulating level or protein carboxylation status of vitamin K, is associated positively with improved joint structural and functional indices and negatively associated with OA incidence. By contrast, in limited retrospective and prospective studies, the use of VKAs is associated positively with OA occurrence and knee/hip replacement. Pharmacological interactions between VKAs and various OA therapeutic agents exist and require careful monitoring and dosing. In conclusion, further epidemiological studies are warranted to verify the relationship between VKA use and OA to strengthen the evidence. Given that VKA use exerts potentially negative effects on joint health, intervention is required to protect the quality of life and mobility of patients.
维生素 K 对于维生素 K 依赖蛋白的羧化作用至关重要，而这些蛋白负责抑制基质钙化。心血管疾病患者使用维生素 K 拮抗剂 (VKA) 可能会影响蛋白羧化作用，并导致骨关节炎 (OA) 的发生。本综述旨在总结 VKA 与 OA 之间关系的现有证据。文献检索显示，在观察性研究中，良好的维生素 K 状态，反映为循环维生素 K 水平或蛋白羧化状态，与改善关节结构和功能指标呈正相关，与 OA 发生率呈负相关。相比之下，在有限的回顾性和前瞻性研究中，VKA 的使用与 OA 的发生和膝关节/髋关节置换呈正相关。VKA 与各种 OA 治疗药物之间存在药物相互作用，需要密切监测和调整剂量。总之，需要进行更多的流行病学研究来验证 VKA 使用与 OA 之间的关系，以加强证据。鉴于 VKA 使用对关节健康可能产生负面影响，需要采取干预措施来保护患者的生活质量和活动能力。
