Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease

British Journal of Nutrition
Q1
Sep 2014
Citations:23
Influential Citations:1
Interventional (Human) Studies
84
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Methods
Two double-blind, randomized, placebo-controlled trials in adults with Crohn’s disease in clinical remission. Study A: 30 participants (18 male, 12 female; mean age 45.5 years) assigned to placebo, 1000 mg/day, or 2000 mg/day phylloquinone for 2 weeks. Study B: 86 randomized (43 placebo; 43 phylloquinone) adults in remission (mean age ~41 years; 48 male, 38 female); 68 completed the 12-month intervention.
Intervention
Study A: Phylloquinone (vitamin K1) administered in 0, 1000, or 2000 mg/day for 2 weeks, taken as two capsules daily with the evening meal; co-administered calcium 500 mg/day and vitamin D3 10 mg/day during the 2-week intervention. Study B: Phylloquinone 1000 mg/day for 12 months, co-administered calcium 500 mg/day and vitamin D3 10 mg/day, taken with the evening meal.
Results
Study A showed that 1000 mg/day phylloquinone nearly maximally suppressed serum undercarboxylated osteocalcin (%ucOC) after 2 weeks; 2000 mg/day did not provide further suppression. Study B found that 12 months of 1000 mg/day phylloquinone (with Ca and vitamin D) did not significantly affect bone turnover markers (BAP, CTx) or bone mineral density in the spine or femur, but modestly increased total radius BMD. Serum ucOC declined and carboxylated osteocalcin (cOC) rose with phylloquinone, indicating improved vitamin K status, but this did not translate into meaningful bone health benefits. Authors concluded that maximizing osteocalcin gamma-carboxylation via high-dose vitamin K1 did not yield clinically meaningful improvements in bone health over 12 months in Crohn’s disease patients in remission.
Limitations
Small sample size in Study A; dropouts and adherence concerns in Study B; serum phylloquinone measured only in a subset (n=27) of Study B due to resource limits; potential assay limitations for ucOC/cOC; participants all had Crohn’s disease in remission with adequate calcium and vitamin D, limiting generalizability to osteoporosis populations.

Abstract

Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (v...