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Vitamin K supplementation reduces serum concentrations of under--carboxylated osteocalcin in healthy young and elderly adults^1,2,3

¹ From the Institute on Aging, Department of Medicine, and the Department of Biochemistry, University of Wisconsin, Madison.

Background: Subclinical vitamin K insufficiency, manifested by under--carboxylation of the bone matrix protein osteocalcin, may be common.

Objective: Our objective was to delineate the prevalence of submaximal -carboxylation as assessed by response to phylloquinone supplementation and to evaluate the effect of this intervention on skeletal turnover in healthy North American adults.

Design: Healthy subjects (n = 219), approximately equally distributed by sex and age (18–30 y and 65 y), received daily phylloquinone (1000 µg) or placebo for 2 wk. Serum undercarboxylated osteocalcin (ucOC) and total osteocalcin, N-telopeptides of type I collagen (NTx), bone-specific alkaline phosphatase (BSAP), and phylloquinone concentrations were measured at baseline and after weeks 1 and 2.

Results: At baseline, the mean serum phylloquinone concentration was lower in the young than in the old group; there was no effect of sex. Concomitantly, baseline %ucOC was highest in the young and lowest in the old men (P < 0.0001) but did not differ significantly by age in women. After supplementation, serum phylloquinone concentration increased 10-fold (P < 0.0001) at week 1 (from 0.93 ± 0.08 to 8.86 ± 0.70 nmol/L, ± SEM); this was sustained through week 2. Among all supplemented groups, mean %ucOC decreased from 7.6% to 3.4% without significant differences by age or sex; 102 of 112 subjects had a >1% decrease. Phylloquinone supplementation reduced serum osteocalcin but did not alter NTx or BSAP concentration.

Conclusions: Usual dietary practices in this population did not provide adequate vitamin K for maximal osteocalcin carboxylation. Phylloquinone supplementation reduced serum osteocalcin concentration but did not alter other markers of serum bone turnover.

Key Words: Vitamin K • phylloquinone • osteocalcin • undercarboxylated osteocalcin • ucOC • bone turnover • osteoporosis • elderly

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