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COMMENTS & OPINIONS
Possible Involvements of Vitamin K in Bone Quality
Toshihiro Sugiyama, MD, PhD
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Oral high-dose vitamin K2 (menaquinone-4, 45 mg/d) has been approved for the treatment of osteoporosis in Japan since 1995, and Cockayne and colleagues1 recently provided a meta-analysis of randomized controlled trials investigating the effects of vitamin K therapy on fracture risk. This analysis showed the strong effect of high-dose vitamin K2 on fracture prevention among Japanese patients. There is no evidence that vitamin K has extraskeletal effects on fracture risk, indicating that this vitamin would restrict bone fragility, which depends on its quantity and quality.2 However, the mechanisms by which vitamin K reduces fracture incidence have been poorly understood.
In postmenopausal Japanese women with osteoporosis, it is well known that high-dose vitamin K2 therapy slightly prevents reduction of areal bone mineral density (BMD) measured by dual-energy x-ray absorptiometry but does not actually increase the areal BMD, suggesting that vitamin K2 improves bone quality. For example, vitamin . . . [Full Text of this Article]
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