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United States Department of Agriculture

Agricultural Research Service

Research Project: VITAMIN K: FOOD COMPOSITION, BIOAVAILABILITY AND IT'S ROLE IN HUMAN HEALTH

Location: Human Nutrition Research Center on Aging

Title: Vitamin K deficiency is associated with incident knee osteoarthritis

Authors
item Misra, Devyani -
item Booth, Sarah L. -
item Tolstykh, Irina -
item Felson, David T. -
item Nevitt, Michael -
item Lewis, Cora E. -
item Torner, James -
item Neogi, Tuhina -

Submitted to: American Journal of Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 1, 2012
Publication Date: March 1, 2013
Citation: Misra, D., Booth, S., Tolstykh, I., Felson, D., Nevitt, M., Lewis, C., Torner, J., Neogi, T. 2013. Vitamin K deficiency is associated with incident knee osteoarthritis. American Journal of Medicine. 126(3):243-248.

Interpretive Summary: Osteoarthritis is the most common form of arthritis, with knee osteoarthritis being the leading cause of lower extremity disability among older adults in the US. There are no treatments available to prevent the development of osteoarthritis. Because of vitamin K’s role in regulating skeletal mineralization, it has potential to be a preventative option for osteoarthritis. We examined associations between vitamin K status and risk for new knee osteoarthritis and its associated changes. The study consisted of 1180 men and women from the Multicenter Osteoarthritis (MOST) Study who had knee x-rays and magnetic resonance imaging obtained at baseline and 30 months later. Vitamin K blood levels were measured at baseline. Study participants averaged 62 years of age and were generally overweight or obese. We examined the associations between low vitamin K blood levels and new cases of knee osteoarthritis, cartilage lesions and osteophytes, which are abnormal bony formations that form along joints. Low blood levels of vitamin K were associated with greater rates of knee osteoarthritis and cartilage lesions, but not with osteophytes. Low blood levels of vitamin K were also associated with a greater likelihood of developing osteoarthritis in one or both knees than neither knee, although these findings were not statistically significant. Further study of vitamin K is warranted given its therapeutic/prophylactic potential for osteoarthritis.

Technical Abstract: Osteoarthritis is the most common form of arthritis, with knee osteoarthritis being the leading cause of lower extremity disability among older adults in the US. There are no treatments available to prevent the structural pathology of osteoarthritis. Because of vitamin K’s role in regulating skeletal mineralization, it has potential to be a preventative option for osteoarthritis. We therefore examined the relation of vitamin K to new onset radiographic knee osteoarthritis and early osteoarthritis changes on MRI. Subjects from the Multicenter Osteoarthritis (MOST) Study had knee x-rays and MRIs obtained at baseline and 30 months later, and plasma phylloquinone measured at baseline. We examined relation of subclinical vitamin K deficiency to incident radiographic knee osteoarthritis and MRI-based cartilage lesions and osteophytes, respectively, using log binomial regression with generalized estimating equations, adjusting for potential confounders. Among 1180 participants (62% women, mean age 62±8 years, mean body mass index 30.1 +/-5.1 kg/m2), subclinical vitamin K deficiency was associated with incident radiographic knee osteoarthritis (RR 1.56, 95% CI 1.08-2.25) and cartilage lesions (RR 2.39, 95% CI 1.05-5.40) compared with no deficiency, but not with osteophytes (RR 2.35, 95% CI 0.54-10.13). Subclinically vitamin K-deficient subjects were more likely to develop osteoarthritis in one or both knees than neither knee (RR 1.33, 95% CI 1.01-1.75 and RR 2.12, 95% CI 1.06-4.24, respectively). In the first such longitudinal study, subclinical vitamin K deficiency was associated with increased risk of developing radiographic knee osteoarthritis and MRI-based cartilage lesions. Further study of vitamin K is warranted given its therapeutic/prophylactic potential for osteoarthritis.

Last Modified: 8/22/2014
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