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Association of dietary and biochemical measures of vitamin K with quantitative ultrasound of the heel in men and women

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Abstract

Introduction

Low vitamin K nutritional status is associated with increased fracture risk but is inconsistently related to bone mineral density (BMD), suggesting that vitamin K may affect components of bone strength not measured by BMD, such as microarchitecture. Quantitative ultrasound (QUS) may assess trabecular orientation, providing information on the mechanical properties of bone and may serve as a potential alternative to BMD for gaining insight to the relation between vitamin K and bone strength. We therefore examined the association of vitamin K nutritional status measured in several different ways with QUS in men and women who participated in the Framingham Osteoporosis Study.

Methods

From 1996 to 2001, broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the calcaneus (heel) were measured in 583 men and 768 women (mean age 59 years). Vitamin K nutritional status was assessed between 1995 and 1998 by three separate measures: plasma phylloquinone concentration, serum percent undercarboxylated osteocalcin (%ucOC) and dietary vitamin K intake. Multiple linear regression analyses were used to calculate regression coefficients in order to evaluate the associations between both measures of QUS and each measure of vitamin K nutritional status. Regression analyses were conducted separately for subgroups of participants defined by gender, menopause status and current use of estrogen replacement medication.

Results

Among the men, plasma phylloquinone concentration was positively associated with both BUA (P<0.01) and SOS (P=0.02) of the heel. Neither serum %ucOC nor dietary vitamin K intake, however, was associated with QUS measures. Among women, none of the three measures of vitamin K nutritional status were associated with either BUA or SOS, regardless of menopause status or use of estrogen. Although QUS is associated with vitamin K nutritional status in men, the observed relation was not consistent among subgroups of participants.

Conclusion

These findings suggest that QUS may not be the best method for elucidating the role of vitamin K on the skeleton.

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References

  1. Binkley NC, Suttie JW (1995) Vitamin K nutrition and osteoporosis. J Nutr 125(7):1812–1821

    PubMed  CAS  Google Scholar 

  2. Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA (1999) Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 69(1):74–79

    PubMed  CAS  Google Scholar 

  3. Szulc P, Chapuy MC, Meunier PJ, Delmas PD (1993) Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture in elderly women. J Clin Invest 91(4):1769–1774

    Article  PubMed  CAS  Google Scholar 

  4. Luukinen H, Kakonen SM, Pettersson K, Koski K, Laippala P, Lovgren T, Kivela SL, Vaananen HK (2000) Strong prediction of fractures among older adults by the ratio of carboxylated to total serum osteocalcin. J Bone Miner Res 15(12):2473–2478

    Article  PubMed  CAS  Google Scholar 

  5. Booth SL, Charette AM (2004) Vitamin K, Oral antigoagulants, and bone health. In: Holick MF, Dawson-Hughes B (eds) Nutrition and bone health. Humana Press, Totowa, pp 475–478

    Google Scholar 

  6. Booth SL, Tucker KL, Chen H, Hannan MT, Gagnon DR, Cupples LA, Wilson PW, Ordovas J, Schaefer EJ, Dawson-Hughes B, Kiel DP (2000) Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 71(5):1201–1208

    PubMed  CAS  Google Scholar 

  7. Ulrich D, van Rietbergen B, Laib A, Ruegsegger P (1999) The ability of three-dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25(1):55–60

    Article  PubMed  CAS  Google Scholar 

  8. Kabel J, van Rietbergen B, Odgaard A, Huiskes R (1999) Constitutive relationships of fabric, density, and elastic properties in cancellous bone architecture. Bone 25(4):481–486

    Article  PubMed  CAS  Google Scholar 

  9. Gluer CC, Wu CY, Genant HK (1993) Broadband ultrasound attenuation signals depend on trabecular orientation: an in vitro study. Osteoporos Int 3(4):185–191

    Article  PubMed  CAS  Google Scholar 

  10. Njeh CF, Kuo CW, Langton CM, Atrah HI, Boivin CM (1997) Prediction of human femoral bone strength using ultrasound velocity and BMD: an in vitro study. Osteoporos Int 7(5):471–477

    Article  PubMed  CAS  Google Scholar 

  11. Nicholson PH, Muller R, Lowet G, Cheng XG, Hildebrand T, Ruegsegger P, van der Perre G, Dequeker J, Boonen S (1998) Do quantitative ultrasound measurements reflect structure independently of density in human vertebral cancellous bone? Bone 23(5):425–431

    Article  PubMed  CAS  Google Scholar 

  12. Liu G, Peacock M (1998) Age-related changes in serum undercarboxylated osteocalcin and its relationships with bone density, bone quality, and hip fracture. Calcif Tissue Int 62(4):286–289

    Article  PubMed  CAS  Google Scholar 

  13. Kannel WB, Feinleib M, McNamara PM, Garrison RJ, Castelli WP (1979) An investigation of coronary heart disease in families. The Framingham offspring study. Am J Epidemiol 110(3):281–290

    PubMed  CAS  Google Scholar 

  14. Davidson KW, Sadowski JA (1997) Determination of vitamin K compounds in plasma or serum by high-performance liquid chromatography using postcolumn chemical reduction and fluorimetric detection. Methods Enzymol 282:408–421

    Article  PubMed  Google Scholar 

  15. Gundberg CM, Nieman SD, Abrams S, Rosen H (1998) Vitamin K status and bone health: an analysis of methods for determination of undercarboxylated osteocalcin. J Clin Endocrinol Metab 83(9):3258–3266

    Article  PubMed  CAS  Google Scholar 

  16. Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135(10):1114–1126; discussion 1127–1136

    PubMed  CAS  Google Scholar 

  17. Langton CM, Palmer SB, Porter RW (1984) The measurement of broadband ultrasonic attenuation in cancellous bone. Eng Med 13(2):89–91

    Article  PubMed  CAS  Google Scholar 

  18. McLean RR, Hannan MT, Epstein BE, Bouxsein ML, Cupples LA, Murabito J, Kiel DP (2000) Elderly cohort study subjects unable to return for follow-up have lower bone mass than those who can return. Am J Epidemiol 151(7):689–692

    PubMed  CAS  Google Scholar 

  19. McNamara JR, Campos H, Ordovas JM, Peterson J, Wilson PW, Schaefer EJ (1987) Effect of gender, age, and lipid status on low density lipoprotein subfraction distribution. Results from the Framingham offspring study. Arteriosclerosis 7(5):483–490

    PubMed  CAS  Google Scholar 

  20. Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA (1999) The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 52(7):643–651

    Article  PubMed  CAS  Google Scholar 

  21. Booth SL, Broe KE, Peterson JW, Cheng DM, Dawson-Hughes B, Gundberg CM, Cupples LA, Wilson PW, Kiel DP (2004) Associations between vitamin K biochemical measures and bone mineral density in men and women. J Clin Endocrinol Metab 89(10):4904–4909

    Article  PubMed  CAS  Google Scholar 

  22. Niemeier A, Kassem M, Toedter K, Wendt D, Ruether W, Beisiegel U, Heeren J (2005) Expression of LRP1 by human osteoblasts: a mechanism for the delivery of lipoproteins and vitamin K1 to bone. J Bone Miner Res 20(2):283–293

    Article  PubMed  CAS  Google Scholar 

  23. McKeown NM, Jacques PF, Gundberg CM, Peterson JW, Tucker KL, Kiel DP, Wilson PW, Booth SL (2002) Dietary and nondietary determinants of vitamin K biochemical measures in men and women. J Nutr 132(6):1329–1334

    PubMed  CAS  Google Scholar 

  24. Booth SL, Broe KE, Gagnon DR, Tucker KL, Hannan MT, McLean RR, Dawson-Hughes B, Wilson PW, Cupples LA, Kiel DP (2003) Vitamin K intake and bone mineral density in women and men. Am J Clin Nutr 77(2):512–516

    PubMed  CAS  Google Scholar 

  25. Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Palermo L, Scott J, Vogt TM (1993) Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341(8837):72–75

    Article  PubMed  CAS  Google Scholar 

  26. Silva MJ, Gibson LJ (1997) Modeling the mechanical behavior of vertebral trabecular bone: effects of age-related changes in microstructure. Bone 21(2):191–199

    Article  PubMed  CAS  Google Scholar 

  27. Oden ZM, Selvitelli DM, Hayes WC, Myers ER (1998) The effect of trabecular structure on DXA-based predictions of bovine bone failure. Calcif Tissue Int 63(1):67–73

    Article  PubMed  CAS  Google Scholar 

  28. Bouxsein ML, Radloff SE (1997) Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone. J Bone Miner Res 12(5):839–846

    Article  PubMed  CAS  Google Scholar 

  29. Lochmuller EM, Eckstein F, Zeller JB, Steldinger R, Putz R (1999) Comparison of quantitative ultrasound in the human calcaneus with mechanical failure loads of the hip and spine. Ultrasound Obstet Gynecol 14(2):125–133

    Article  PubMed  CAS  Google Scholar 

  30. Toyras J, Kroger H, Jurvelin JS (1999) Bone properties as estimated by mineral density, ultrasound attenuation, and velocity. Bone 25(6):725–731

    Google Scholar 

  31. Wu C, Hans D, He Y, Fan B, Njeh CF, Augat P, Richards J, Genant HK (2000) Prediction of bone strength of distal forearm using radius bone mineral density and phalangeal speed of sound. Bone 26(5):529–533

    Article  PubMed  CAS  Google Scholar 

  32. Bauer DC, Gluer CC, Cauley JA, Vogt TM, Ensrud KE, Genant HK, Black DM (1997) Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 157(6):629–634

    Article  PubMed  CAS  Google Scholar 

  33. Pluijm SM, Graafmans WC, Bouter LM, Lips P (1999) Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. Osteoporos Int 9(6):550–556

    Article  PubMed  CAS  Google Scholar 

  34. Frost ML, Blake GM, Fogelman I (2001) Quantitative ultrasound and bone mineral density are equally strongly associated with risk factors for osteoporosis. J Bone Miner Res 16(2):406–416

    Article  PubMed  CAS  Google Scholar 

  35. Booth SL, Pennington JA, Sadowski JA (1996) Food sources and dietary intakes of vitamin K–1 (phylloquinone) in the American diet: data from the FDA Total Diet Study. J Am Diet Assoc 96(2):149–154

    Article  PubMed  CAS  Google Scholar 

  36. Booth SL, Suttie JW (1998) Dietary intake and adequacy of vitamin K. J Nutr 128(5):785–788

    PubMed  CAS  Google Scholar 

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Acknowledgements

We are grateful to the Framingham Study Participants and staff, especially the Framingham densitometer technician, Mary Hogan, and the Framingham Study laboratory chief, Patrice Sutherland, and her staff. We also thank James Peterson and Caren Gundberg for their technical contributions. This work was supported by the National Institute of Aging (AG14759), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR/AG41398), the US Department of Agriculture under agreement 58-1950-001, and by the National Heart, Lung and Blood Institute’s Framingham Heart Study (N01-HC-25195).

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Authors and Affiliations

  1. Institute for Aging Research at Hebrew SeniorLife, 1200 Centre Street, Boston, MA, 02131, USA

    R. R. McLean, D. P. Kiel, K. E. Broe & M. T. Hannan

  2. Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA

    S. L. Booth & K. L. Tucker

  3. Harvard Medical School, Boston, Massachusetts, USA

    D. P. Kiel & M. T. Hannan

  4. Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA

    D. R. Gagnon & L. A. Cupples

Authors
  1. R. R. McLean
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  2. S. L. Booth
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  3. D. P. Kiel
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  4. K. E. Broe
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  5. D. R. Gagnon
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  6. K. L. Tucker
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  7. L. A. Cupples
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  8. M. T. Hannan
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Corresponding author

Correspondence to R. R. McLean.

Additional information

From the Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine, Framingham, Massachusetts, USA.

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McLean, R.R., Booth, S.L., Kiel, D.P. et al. Association of dietary and biochemical measures of vitamin K with quantitative ultrasound of the heel in men and women. Osteoporos Int 17, 600–607 (2006). https://doi.org/10.1007/s00198-005-0022-9

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  • DOI: https://doi.org/10.1007/s00198-005-0022-9

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