Xie Chenqi, Gong Jianbao, Zheng Chenglong, Zhang Junwei, Gao Jie, Tian Chunyan, Guo Xiaofei, Dai Shiyou, Gao Tianlin
Department of Osteoarthrosis, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, China.
School of Public Health, Qingdao University, Qingdao, China.
Bone Joint Res. 2024 Dec 11;13(12):750-763. doi: 10.1302/2046-3758.1312.BJR-2024-0053.R1.
This meta-analysis and systematic review aimed to comprehensively investigate the effects of vitamin K supplementation on bone mineral density (BMD) at various sites and bone metabolism in middle-aged and older adults.
The databases of PubMed, Web of Science, and Cochrane Library were thoroughly searched from inception to July 2023.
The results revealed that vitamin K supplementation increased BMD at the lumbar spine (p = 0.035). Moreover, the pooled effects demonstrated a notable increase in carboxylated osteocalcin (cOC) (p = 0.004), a decrease in uncarboxylated osteocalcin (ucOC) (p < 0.001), and no significant effect on total osteocalcin (tOC) (p = 0.076). Accordingly, the ratio of cOC to ucOC (p = 0.002) significantly increased, while the ratio of ucOC to tOC decreased (p = 0.043). However, there was no significant effect of vitamin K supplementation on other bone metabolism markers, such as cross-linked telopeptide of type 1 collagen (NTx), bone alkaline phosphatase (BAP), and procollagen I N-terminal propeptide (PINP). Subgroup analysis revealed that vitamin K notably enhanced bone health in females by increasing lumbar spine BMD (p = 0.028) and decreasing ucOC (p < 0.001). Vitamin K, especially vitamin K2, exhibited effects on maintaining or increasing lumbar spine BMD, and influencing the balance of cOC and ucOC.
This review suggests that the beneficial effects of vitamin K supplementation on bone health primarily involve enhancing the carboxylation of OC rather than altering the total amount of OC.
本荟萃分析和系统评价旨在全面研究补充维生素K对中老年人不同部位骨密度（BMD）及骨代谢的影响。
全面检索了PubMed、Web of Science和Cochrane图书馆数据库，检索时间从数据库创建至2023年7月。
结果显示，补充维生素K可提高腰椎骨密度（p = 0.035）。此外，汇总效应表明羧化骨钙素（cOC）显著增加（p = 0.004），未羧化骨钙素（ucOC）减少（p < 0.001），而对总骨钙素（tOC）无显著影响（p = 0.076）。因此，cOC与ucOC的比值显著增加（p = 0.002），而ucOC与tOC的比值降低（p = 0.043）。然而，补充维生素K对其他骨代谢标志物，如1型胶原交联端肽（NTx）、骨碱性磷酸酶（BAP）和前胶原I N端前肽（PINP）无显著影响。亚组分析显示，维生素K通过增加腰椎骨密度（p = 0.028）和降低ucOC（p < 0.001）显著改善女性骨骼健康。维生素K，尤其是维生素K2，对维持或增加腰椎骨密度以及影响cOC和ucOC的平衡具有作用。
本综述表明，补充维生素K对骨骼健康的有益作用主要涉及增强骨钙素的羧化作用，而非改变骨钙素的总量。
