Journal of Bone and Mineral Metabolism

, Volume 35, Issue 5, pp 529–535 | Cite as

Vitamin K homologs as potential biomarkers for disease activity in patients with rheumatoid arthritis

  • Hani M. Khojah
  • Sameh Ahmed
  • Mahran S. Abdel-Rahman
  • Khaled M. Alkhalil
  • Al-Badr Hamza
Original Article


The aim of this study was to evaluate the possible role of vitamin K homologs as potential biomarkers for disease activity in patients with rheumatoid arthritis (RA). In this study, 42 patients with RA and 40 healthy controls were enrolled. Serum levels of vitamin K homologs were measured using a high-performance liquid chromatography-fluorescence method. Different biochemical and clinical markers for disease activity were measured and correlated with serum levels of vitamin K homologs. There were no significant differences between RA patients and healthy subjects in demographic data. Patients with RA showed significantly higher levels of biochemical markers compared with healthy subjects (p < 0.001). These markers included rheumatoid factor (RF), anticyclic citrullinated polypeptide (anti-CCP), undercarboxylated osteocalcin (ucOC), matrix metalloproteinase (MMP-3), C-reactive protein (CRP), and disease activity score assessing 28 joints with erythrocyte sedimentation rate (DAS28-ESR). In addition, serum levels of vitamin K homologs were reduced in RA patients, and the levels of menaquinone-4 (MK-4) and menaquinone-7 (MK-7) were moderately to strongly inversely correlated with the clinical articular features in RA patients, whereas phylloquinone (PK) levels were weakly correlated. Serum levels of MK-4, MK-7 and PK were strongly inversely correlated with ucOC, MMP-3 and DAS28-ESR in RA patients. In contrast, serum levels of MK-4, MK-7 and PK were weakly correlated with CRP, RF and anti-CCP. These results suggest that serum levels of vitamin K homologs may be considered as potential biomarkers for disease activity. In addition, the results confirm the role of vitamin K deficiency in the etiology of RA.


Vitamin K homologs Rheumatoid arthritis Biomarkers DAS28-ESR Matrix metalloproteinase 



The authors thank King Fahd Hospital in Almadinah Almunawarh, Saudi Arabia for the support and offering the use of its facilities for this project. The project was funded by Taibah University Deanship of Scientific Research, Project No. 4121/434.

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2016

Authors and Affiliations

  • Hani M. Khojah
    • 1
  • Sameh Ahmed
    • 2
  • Mahran S. Abdel-Rahman
    • 3
    • 4
  • Khaled M. Alkhalil
    • 5
  • Al-Badr Hamza
    • 5
  1. 1.Department of Clinical and Hospital Pharmacy, College of PharmacyTaibah UniversityAl Madinah AlMunawarahSaudi Arabia
  2. 2.Department of Pharmacognosy and Pharmaceutical Chemistry, College of PharmacyTaibah UniversityAl Madinah AlMunawarahSaudi Arabia
  3. 3.Department of Pharmacology and Toxicology, College of PharmacyTaibah UniversityAl Madinah AlMunawarahSaudi Arabia
  4. 4.Department of Pharmacology, Faculty of MedicineAssiut UniversityAssiutEgypt
  5. 5.Department of RheumatologyKing Fahd HospitalAl Madinah AlMunawarahSaudi Arabia

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