Vitamin K Status and Skeletal Fragility: Differential Associations of Osteocalcin Carboxylation States with Bone Strength, Geometry and Microarchitecture
Abstract
Background: The contribution of specific nutritional biomarkers to skeletal fragility remains poorly understood, in part because most studies include participants with metabolic conditions that obscure nutrient-specific effects. We aimed to examine incremental contribution of six pathway-specific nutritional biomarkers. Methods: In a prospective cross-sectional case-control design, 108 patients undergoing arthroplasty were enrolled (hip-fracture, n = 63; non-fracture, n = 45), and bone biopsies and blood specimens were collected intraoperatively. Circulating biomarkers reflecting vitamin K, one-carbon metabolism, antioxidant nutrients (vitamins E and C), protein and zinc status were measured. Bone outcomes included remodelling markers, trabecular microarchitecture and bone strength. Hierarchical regression was used to quantify the incremental contribution of nutritional biomarkers beyond clinical covariates with a priori outcome selection. Results: Bone remodelling markers did not differ between groups after covariate adjustment, indicating that fractures in this cohort were characterised by deficits in bone strength and quality rather than elevated systemic remodelling activity. Among six nutritional pathways tested, only vitamin K-dependent biomarkers showed consistent independent associations with bone outcomes, suggesting a degree of pathway specificity. Critically, carboxylated (cOC), undercarboxylated (ucOC) and fully uncarboxylated (unOC) osteocalcin fractions showed…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 108 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.