Osteoporosis International

, Volume 30, Issue 8, pp 1543–1559 | Cite as

Effect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials

  • A. MottEmail author
  • T. Bradley
  • K. Wright
  • E. S. Cockayne
  • M. J. Shearer
  • J. Adamson
  • S. A. Lanham-New
  • D. J. Torgerson
Review Article



Vitamin K may affect bone mineral density and fracture incidence. Since publication of a previous systematic review the integrity of some of the previous evidence has been questioned and further trials have been published. Therefore an update to the systematic review was required.


This systematic review was designed to assess the effectiveness of oral vitamin K supplementation for increasing bone mineral density and reducing fractures in adults.


MEDLINE, EMBASE, CENTRAL, CINAHL,, and WHO-ICTRP were searched for eligible trials. Randomised controlled trials assessing oral vitamin K supplementation that assessed bone mineral density or fractures in adult populations were included. A total of 36 studies were identified. Two independent reviewers extracted data using a piloted extraction form.


For post-menopausal or osteoporotic patients, meta-analysis showed that the odds of any clinical fracture were lower for vitamin K compared to controls (OR, 0.72, 95%CI 0.55 to 0.95). Restricting the analysis to low risk of bias trials reduced the OR to 0.76 (95%CI, 0.58 to 1.01). There was no difference in vertebral fractures between the groups (OR 0.96, 95%CI 0.83 to 1.11). In the bone mineral density meta-analysis, percentage change from baseline at the lumbar spine was higher at 1 year (MD 0.93, 95%, CI − 0.02 to 1.89) and 2 years (MD 1.63%, 95%CI 0.10 to 3.16) for vitamin K compared to controls; however, removing trials at high risk of bias tended to result in smaller differences that were not statistically significant. At 6 months, it was higher in the hip (MD 0.42%, 95%CI 0.01 to 0.83) and femur (MD 0.29%, 95%CI 0.17 to 0.42). There was no significant difference at other anatomical sites.


For post-menopausal or osteoporotic patients, there is no evidence that vitamin K affects bone mineral density or vertebral fractures; it may reduce clinical fractures; however, the evidence is insufficient to confirm this. There are too few trials to draw conclusions for other patient groups.


Bone health Bone mineral density Fracture Osteoporosis Systematic review Vitamin K 



There was no funding for this systematic review.

Compliance with ethical standards

Conflicts of interest


Supplementary material

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  1. 1.York Trials Unit, Department of Health SciencesUniversity of YorkYorkUK
  2. 2.Chesterfield HospitalCalowUK
  3. 3.Centre for Reviews & DisseminationUniversity of YorkYorkUK
  4. 4.Centre for Haemostasis and ThrombosisGuy’s and St Thomas’ NHS TrustLondonUK
  5. 5.Institute of Health & SocietyNewcastle UniversityNewcastle upon TyneUK
  6. 6.Nutritional Sciences Department, School of Biosciences and Medicine, Faculty of Health and Medical SciencesUniversity of SurreyGuildfordUK

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