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Hip fracture 50 percent more likely if low in both vitamin D and vitamin K1 – Dec 2015

A combination of low serum concentrations of vitamins K1 and D is associated with increased risk of hip fractures in elderly Norwegians: a NOREPOS study.

Osteoporos Int. 2015 Dec 2. [Epub ahead of print]
Finnes TE1,2, Lofthus CM3, Meyer HE4,5, Søgaard AJ5, Tell GS6, Apalset EM6,7, Gjesdal C7,8, Grimnes G9,10, Schei B11, Blomhoff R12,13, Samuelsen SO5,14, Holvik K5.

VitaminDWiki Summary

Measured levels of Vitamin D and Vitamin K1 in 70 year-old men and women
8 years later hip fractures 50% higher in
vitamin K1 < 0.76 and 25(OH)D < 50 nmol/l (<20 nanogram)
Vs vitamin K1 ≥ 0.76 and 25(OH)D ≥ 50 nmol/l,
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1Department of Internal Medicine, Innlandet Hospital Trust, Skolegata 32, N-2318, Hamar, Norway. trine_finnes at yahoo.com.
2Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. trine_finnes at yahoo.com.
3Department of Endocrinology, Oslo University Hospital, Oslo, Norway.
4Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
5Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
6Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
7Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
8Department of Clinical Science, University of Bergen, Bergen, Norway.
9Department of Clinical Medicine, Arctic University of Norway, Tromsø, Norway.
10Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
11Department of Public Health and General Practice Norwegian, University of Science and Technology, Trondheim, Norway.
12Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
13Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway.
14Department of Mathematics, University of Oslo, Oslo, Norway.

The present study investigated the risk of incident hip fractures according to serum concentrations of vitamin K1 and 25-hydroxyvitamin D in elderly Norwegians during long-term follow-up. The results showed that the combination of low concentrations of both vitamin D and K1 provides a significant risk factor for hip fractures.

INTRODUCTION:
This case-cohort study aims to investigate the associations between serum vitamin K1 and hip fracture and the possible effect of 25-hydroxyvitamin D (25(OH)D) on this association.

METHODS:
The source cohort was 21,774 men and women aged 65 to 79 years who attended Norwegian community-based health studies during 1994-2001. Hip fractures were identified through hospital registers during median follow-up of 8.2 years. Vitamins were determined in serum obtained at baseline in all hip fracture cases (n = 1090) and in a randomly selected subcohort (n = 1318). Cox proportional hazards regression with quartiles of serum vitamin K1 as explanatory variable was performed. Analyses were further performed with the following four groups as explanatory variable:
I: vitamin K1 ≥ 0.76 and 25(OH)D ≥ 50 nmol/l,

  • II: vitamin K1 ≥ 0.76 and 25(OH)D < 50 nmol/l,
  • III: vitamin K1 < 0.76 and 25(OH)D ≥ 50 nmol/l, and
  • IV: vitamin K1 < 0.76 and 25(OH)D < 50 nmol/l.

RESULTS:
Age- and sex-adjusted analyses revealed an inverse association between quartiles of vitamin K1 and the risk of hip fracture. Further, a 50 % higher risk of hip fracture was observed in subjects with both low vitamin K1 and 25(OH)D compared with subjects with high vitamin K1 and 25(OH)D (HR 1.50, 95 % CI 1.18-1.90). The association remained statistically significant after adjusting for

  • body mass index,
  • smoking, triglycerides, and
  • serum α-tocopherol.

No increased risk was observed in the groups low in one vitamin only.

CONCLUSION:
Combination of low concentrations of vitamin K1 and 25(OH)D is associated with increased risk of hip fractures.

PMID: 26630974

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