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Vitamin K2, a cofactor in the carboxylation of osteocalcin, is recognized as a protector against bone loss and fractures in postmenopausal women. Functionally, the availability of vitamin K regulates the carboxylation of osteocalcin. “Epidemiological studies have found associations between serum undercarboxylated osteocalcin (ucOC) and the risk of hip fracture in elderly women[1] and between low intake of vitamin K1 and risk of hip fracture in older men and women.[2]” In this randomized, placebo-controlled, double-blinded clinical trial, supplementation with Vitamin K2 as MK-7 at a dose of 375ug or placebo for 12 months was evaluated for its benefits on bone mineral density. This was evaluated by “dual X-ray absorptiometry (DXA), bone microarchitecture, measured by high-resolution peripheral quantitative computed tomography (HRpQCT), and [additional] biochemical bone turnover markers, in 148 postmenopausal women with osteopenia.”
All patients were also supplemented with calcium (800mg) and vitamin D (38µg). The change in undercarboxylated osteocalcin (ucOC) was determined as the primary endpoint. Following “6 months, the changes were -72.3% (-77.0; -66.6%) in the MK-7 group and -8.0 (-15.3; -0.1%) in the placebo group (P<0.01). Following 12 months the changes were -70.3 (-63.8; -75.6%) in the MK-7 group and -7.2 (-15.9; 2.0%) in the placebo group (P<0.01).”
Changes in total osteocalcin also differed between the two groups. “Following 12 months the changes were -18.8 ± 13.9% in the MK-7 group and -2.5 ± 12.8% in the placebo group (P < 0.01).”
Thus, it was concluded that “treatment with MK-7, 365ug daily, in addition to calcium and vitamin D, for 12 months reduced serum levels of undercarboxylated osteocalcin by more than 70%, reduced the ratio ucOC/OC by more than 60%, increased bone-specific alkaline phosphatase (BAP) by 5%, and maintained microarchitecture in trabecular bone in tibia, despite no significant effects on BMD.”
Ref.: Ronn SH, Harslof T, Pedersen SB, Langdahl BL. Vitamin K2 (menaquinone-7) prevents age-related deterioration of trabecular bone microarchitecture at the tibia in postmenopausal women. European Journal of Endocrinology. (2016) 175(6):541–549.
[1] Szulc P, Chapuy MC, Meunier PJ & Delmas PD. Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture in elderly women. J Clinical Investigation. 1993 91 1769–1774. (doi:10.1172/JCI116387)
[2] Booth SL, Tucker KL, Chen H, Hannan MT, Gagnon DR, Cupples LA, Wilson PW, Ordovas J, Schaefer EJ, Dawson-Hughes B et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr. 2000 71 1201–1208.
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