Serial changes in serum vitamin K₁, triglyceride, cholesterol, osteocalcin and 25‐hydroxyvitamin D₃ in patients after hip replacement for fractured neck of femur or osteoarthritis

Abstract

Serum vitamin K1 concentrations were measured at presentation (just before surgery) and then at weekly intervals for 3 weeks in two groups of elderly patients requiring either hemiarthroplasty for fractured neck of femur (FON, n = 13) or total hip replacement for osteoarthritis of the hip (OA, n = 16). In comparison with healthy elderly volunteers (n = 25), serum vitamin K1 concentrations were significantly lower in both groups at presentation, and fell significantly within 24 h after surgery to concentrations approaching non-detectable, subsequently returning to pre-operative values within 3 weeks. Serum vitamin K1 tended to be lower in the fracture group both before and after operation, although calculation of a vitamin K1-triglyceride ratio reduced the apparent difference as triglyceride concentrations were lower in the fracture group. Osteocalcin concentrations were similar and fell significantly after operation in both groups, returning to pre-operative levels within 7 days. No differences in the two forms of osteocalcin (carboxylated and undercarboxylated) were observed either before or after operation in either group. 25-Hydroxyvitamin D3 concentrations were not significantly different between the two groups at any time. Vitamin K1 status may be lower than desirable in certain groups of the elderly population, and supplementation should be considered as prophylactic therapy.

Ethnic differences in osteocalcin γ-carboxylation, plasma phylloquinone (vitamin K1) and apolipoprotein E genotype

“…The plasma phylloquinone concentrations in this British cohort were comparable to previous studies (Hart et al, 1985;Bitensky et al, 1988;Roberts et al, 1996). Studies in the USA have reported higher absolute phylloquinone levels in elderly compared to younger subjects (Sadowski et al, 1989;Sokoll & Sadowski, 1996).…”

“…To our knowledge, this is the first report of plasma phylloquinone concentrations in Chinese and African subjects. The high phylloquinone concentrations in the cohort of Chinese women from Shenyang where osteoporotic fractures are rare (Yan et al, 1999), is compatible with the association of low circulating phylloquinone with a high incidence of osteoporotic fracture in Britain and North America (Hart et al, 1985;Bitensky et al, 1988;Roberts et al, 1996;Booth et al, 2000). Plasma phylloquinone concentration is readily affected by dietary intake and rapidly raises blood concentrations, which then fall within a few hours (Suttie et al, 1988;Ferland et al, 1993;Sokoll et al, 1997;Booth et al, 1999).…”

Relationship between serum undercarboxylated osteocalcin and hyaluronan levels in patients with bilateral knee osteoarthritis

“…Roberts et al (22) have reported that vitamin K concentration is low in osteoarthritis patients, but they have not mentioned the relationship between vitamin K concentration and cartilage metabolism. In this regard, this is the first study to consider this relationship in patients with bilateral K-OA.…”

Vitamin K and metabolic bone disease.

“…18 19 More recently these data were confirmed, 20 and it was found that plasma menaquinone concentrations were also substantially reduced in these patients. 21 Because it was not clear from these data whether the observed low circulating vitamin K levels were associated with a detectable vitamin K deficiency in bone tissue, Knapen et al developed an assay to assess the ratio between normal and undercarboxylated osteocalcin, and found that the fraction of undercarboxylated osteocalcin was increased in postmenopausal women.…”