Efficacy of Vitamin K₂ for Glucocorticoid-induced Osteoporosis in Patients with Systemic Autoimmune Diseases

Abstract

Objective Vitamin K2 (menatetrenone) is an effective treatment for patients with postmenopausal osteoporosis. We herein performed a subanalysis of patients with systemic autoimmune diseases undergoing glucocorticoid therapy in our previous prospective study. Methods Sixty patients were categorized into a group with vitamin K2 treatment (n=20, Group A) and a group without vitamin K2 treatment (n=40, Group B). All patients were treated with bisphosphonates. Results Serum levels of osteocalcin and undercarboxylated osteocalcin decreased significantly after the start of glucocorticoid therapy in both groups, while the serum osteocalcin level was significantly higher in Group A than Group B during the third (p=0.0250) and fourth weeks (p=0.0155). The serum level of the N-terminal peptide of type I procollagen, a bone formation marker, decreased during glucocorticoid therapy, but was significantly higher in Group A than Group B during the fourth week (p=0.0400). The bone mineral density and fracture rate showed no significant differences between the two groups. Conclusion Although vitamin K2 improves bone turnover markers in patients with osteoporosis on glucocorticoid therapy, it has no significant effect on the bone mineral density and fracture rate after 1.5 years of treatment.

Genistein and menaquinone-4 treatment-induced alterations in the expression of mRNAs and their products are beneficial to osteoblastic MC3T3-E1 cell functions

“…However, WNT5A is usually considered to promote osteoclast differentiation and prevent adipocyte differentiation (26). Genistein alone (27) and MK-4 alone (28,29) reportedly promote bone formation; however, in the current study, their co-administration appeared to be more beneficial as it allowed the maintenance of NOTCH2 and WNT5A mRNAs at the levels observed in the control cells.…”

Vitamin K1 and Vitamin K2 immunopharmacological effects on the peripheral lymphocytes of healthy subjects and dialysis patients, as estimated by the lymphocyte immunosuppressant sensitivity test

“…Shikano et al reported that VK2 improves the levels of bone turnover markers in autoimmune disease patients with glucocorticoid‐induced osteoporosis. Furthermore, Ebina et al reported that the CRP, MMP‐3 and DAS28‐CRP levels were significantly decreased after 3 months of VK2 treatment in rheumatoid arthritis patients.…”

The Potential of Vitamin K as a Regulatory Factor of Bone Metabolism—A Review

“…These discrepancies may be due to the high dietary intake of VK, which may have limited the ability to analyze the association between VK intake and fracture risk. On the other hand, Shikano et al [86] found that VK improved bone turnover markers, while it did not affect BMD and fracture after 1.5 years in patients with osteoporosis on bisphosphonate therapy. Other similar studies suggested that combined therapy with risedronate and VK2 could not prevent vertebral fracture incidence in postmenopausal osteoporosis [85,87].…”