Comparison of biochemical indexes for assessing vitamin K nutritional status in a healthy adult population.

Biochemical indexes for assessing vitamin K nutritional status were evaluated in 263 healthy subjects (127 males, 136 females) aged 18-85 y. The influences of aging (stratified by decade), menopause, and sex were examined. Total, carboxylated, and undercarboxylated osteocalcin concentrations were affected by sex and aging with increases in the sixth decade in women attributed to menopause. Aging effects in the women and sex differences were eliminated when undercarboxylated osteocalcin was expressed as a percentage of the total. Plasma phylloquinone and undercarboxylated prothrombin (PIVKA-II) concentrations varied little with aging with the exception of lower concentrations of phylloquinone in women in their third decade compared with other ages and higher concentrations of PIVKA-II in younger males compared with younger females. Urinary gamma-carboxyglutamic acid (Gla)-creatinine excretion ratios increased significantly with age in both males (r = 0.68, P < 0.001) and females (r = 0.63, P < 0.001) with values 20% higher in the females on average over the entire age span. The undercarboxylated osteocalcin concentration, shown previously to be responsive to depletion and repletion of phylloquinone, was compared with the other indexes to determine its reliability as an indicator of vitamin K nutritional status. This measure appears promising because it correlated with plasma PIVKA-II concentrations (r = 0.27, P < 0.001) and with plasma phylloquinone concentrations (r = -0.35, P < 0.001), whereas the agreement between plasma phylloquinone and PIVKA-II concentrations was not as strong (r = -0.15, P < 0.05).