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A combination of low serum concentrations of vitamins K1 and D is associated with increased risk of hip fractures in elderly Norwegians: a NOREPOS study

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Abstract

Summary

The present study investigated the risk of incident hip fractures according to serum concentrations of vitamin K1 and 25-hydroxyvitamin D in elderly Norwegians during long-term follow-up. The results showed that the combination of low concentrations of both vitamin D and K1 provides a significant risk factor for hip fractures.

Introduction

This case-cohort study aims to investigate the associations between serum vitamin K1 and hip fracture and the possible effect of 25-hydroxyvitamin D (25(OH)D) on this association.

Methods

The source cohort was 21,774 men and women aged 65 to 79 years who attended Norwegian community-based health studies during 1994–2001. Hip fractures were identified through hospital registers during median follow-up of 8.2 years. Vitamins were determined in serum obtained at baseline in all hip fracture cases (n = 1090) and in a randomly selected subcohort (n = 1318). Cox proportional hazards regression with quartiles of serum vitamin K1 as explanatory variable was performed. Analyses were further performed with the following four groups as explanatory variable: I: vitamin K1 ≥ 0.76 and 25(OH)D ≥ 50 nmol/l, II: vitamin K1 ≥ 0.76 and 25(OH)D < 50 nmol/l, III: vitamin K1 < 0.76 and 25(OH)D ≥ 50 nmol/l, and IV: vitamin K1 < 0.76 and 25(OH)D < 50 nmol/l.

Results

Age- and sex-adjusted analyses revealed an inverse association between quartiles of vitamin K1 and the risk of hip fracture. Further, a 50 % higher risk of hip fracture was observed in subjects with both low vitamin K1 and 25(OH)D compared with subjects with high vitamin K1 and 25(OH)D (HR 1.50, 95 % CI 1.18–1.90). The association remained statistically significant after adjusting for body mass index, smoking, triglycerides, and serum α-tocopherol. No increased risk was observed in the groups low in one vitamin only.

Conclusion

Combination of low concentrations of vitamin K1 and 25(OH)D is associated with increased risk of hip fractures.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Innlandet Hospital Trust, Skolegata 32, N-2318, Hamar, Norway

    T. E. Finnes

  2. Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway

    T. E. Finnes & H. E. Meyer

  3. Department of Endocrinology, Oslo University Hospital, Oslo, Norway

    C. M. Lofthus

  4. Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway

    H. E. Meyer, A. J. Søgaard, S. O. Samuelsen & K. Holvik

  5. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

    G. S. Tell & E. M. Apalset

  6. Department of Rheumatology, Haukeland University Hospital, Bergen, Norway

    E. M. Apalset & C. Gjesdal

  7. Department of Clinical Science, University of Bergen, Bergen, Norway

    C. Gjesdal

  8. Department of Clinical Medicine, Arctic University of Norway, Tromsø, Norway

    G. Grimnes

  9. Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

    G. Grimnes

  10. Department of Public Health and General Practice Norwegian, University of Science and Technology, Trondheim, Norway

    B. Schei

  11. Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway

    R. Blomhoff

  12. Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway

    R. Blomhoff

  13. Department of Mathematics, University of Oslo, Oslo, Norway

    S. O. Samuelsen

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  1. T. E. Finnes
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  2. C. M. Lofthus
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  3. H. E. Meyer
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  7. C. Gjesdal
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  8. G. Grimnes
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  9. B. Schei
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  11. S. O. Samuelsen
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  12. K. Holvik
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Corresponding author

Correspondence to T. E. Finnes.

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Conflicts of interest

Trine Elisabeth Finnes, Cathrine Marie Lofthus, Haakon Eduard Meyer, Anne Johanne Søgaard, Grethe S. Tell, Ellen Margrethe Apalset, Clara Gjesdal, Guri Grimnes, Berit Schei, Sven Ove Samuelsen, and Kristin Holvik declare that they have no conflict of interest. Rune Blomhoff has an interest (ownership) in the chemical analysis company Vitas AS (established by the Oslo Innovation Centre)

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Finnes, T.E., Lofthus, C.M., Meyer, H.E. et al. A combination of low serum concentrations of vitamins K1 and D is associated with increased risk of hip fractures in elderly Norwegians: a NOREPOS study. Osteoporos Int 27, 1645–1652 (2016). https://doi.org/10.1007/s00198-015-3435-0

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  • DOI: https://doi.org/10.1007/s00198-015-3435-0

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