The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials
Abstract Background With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-10-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02728-4 |
| _version_ | 1811186587199864832 |
|---|---|
| author | Liyou Hu Jindou Ji Dong Li Jing Meng Bo Yu |
| author_facet | Liyou Hu Jindou Ji Dong Li Jing Meng Bo Yu |
| author_sort | Liyou Hu |
| collection | DOAJ |
| description | Abstract Background With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. We conducted a systematic review of randomized controlled trials to assess the effect of this combination treatment on BMD and UcOC in humans. Methods A search for articles was conducted using PubMed, Embase, and the Cochrane Library database up to March 2021 (no language restrictions). We also reviewed the reference lists of the relevant publications and reviews to locate additional publications. The standard mean difference (SMD) was used as the primary measure of effect size. Our main endpoints were lumbar BMD, femoral neck BMD, hip BMD, total femoral BMD, and UcOC from baseline to end point. We performed subgroup analysis, heterogeneity testing, and assessment of publication bias. Results A total of 1346 patients from 10 randomized controlled trials were included in the meta-analysis. The forest plot analysis revealed that vitamin K combined with calcium was associated with a higher lumbar spine BMD compared to controls. The SMD was 0.20 [95% confidence interval (CI): 0.07 to 0.32]. Vitamin K and calcium supplementation led to a significant decrease in UcOC (SMD: − 1.71, 95% CI: − 2.45 to − 0.96). Subgroup analysis showed that vitamin K2 and vitamin K1 had SMDs of 0.30 (95% CI: 0.10 to 0.51) and SMDs of 0.14 (95% CI: − 0.02 to 0.29), and calcium dosages of ≤ 1000 mg/d or > 1000 mg/d had SMDs of 0.19 (95% CI: 0.05 to 0.32) and 0.26 (95% CI: − 0.04 to 0.55). Conclusion The combination of vitamin K and calcium has a positive effect on lumbar BMD and decreases the level of UcOC. Registration: The protocol for this meta-analysis was registered at the International Prospective Register of Systematic Reviews (CRD42021251825). |
| first_indexed | 2024-04-11T13:47:56Z |
| format | Article |
| id | doaj.art-ffa3f48e78944dd5aab9a82e2d3f5fda |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:47:56Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-ffa3f48e78944dd5aab9a82e2d3f5fda2022-12-22T04:20:55ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-0116111110.1186/s13018-021-02728-4The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trialsLiyou Hu0Jindou Ji1Dong Li2Jing Meng3Bo Yu4Shandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineDepartment of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese MedicineAbstract Background With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. We conducted a systematic review of randomized controlled trials to assess the effect of this combination treatment on BMD and UcOC in humans. Methods A search for articles was conducted using PubMed, Embase, and the Cochrane Library database up to March 2021 (no language restrictions). We also reviewed the reference lists of the relevant publications and reviews to locate additional publications. The standard mean difference (SMD) was used as the primary measure of effect size. Our main endpoints were lumbar BMD, femoral neck BMD, hip BMD, total femoral BMD, and UcOC from baseline to end point. We performed subgroup analysis, heterogeneity testing, and assessment of publication bias. Results A total of 1346 patients from 10 randomized controlled trials were included in the meta-analysis. The forest plot analysis revealed that vitamin K combined with calcium was associated with a higher lumbar spine BMD compared to controls. The SMD was 0.20 [95% confidence interval (CI): 0.07 to 0.32]. Vitamin K and calcium supplementation led to a significant decrease in UcOC (SMD: − 1.71, 95% CI: − 2.45 to − 0.96). Subgroup analysis showed that vitamin K2 and vitamin K1 had SMDs of 0.30 (95% CI: 0.10 to 0.51) and SMDs of 0.14 (95% CI: − 0.02 to 0.29), and calcium dosages of ≤ 1000 mg/d or > 1000 mg/d had SMDs of 0.19 (95% CI: 0.05 to 0.32) and 0.26 (95% CI: − 0.04 to 0.55). Conclusion The combination of vitamin K and calcium has a positive effect on lumbar BMD and decreases the level of UcOC. Registration: The protocol for this meta-analysis was registered at the International Prospective Register of Systematic Reviews (CRD42021251825).https://doi.org/10.1186/s13018-021-02728-4Bone mineral densityUcOCVitamin KCalciumSystematic review |
| spellingShingle | Liyou Hu Jindou Ji Dong Li Jing Meng Bo Yu The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials Journal of Orthopaedic Surgery and Research Bone mineral density UcOC Vitamin K Calcium Systematic review |
| title | The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials |
| title_full | The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials |
| title_fullStr | The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials |
| title_full_unstemmed | The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials |
| title_short | The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials |
| title_sort | combined effect of vitamin k and calcium on bone mineral density in humans a meta analysis of randomized controlled trials |
| topic | Bone mineral density UcOC Vitamin K Calcium Systematic review |
| url | https://doi.org/10.1186/s13018-021-02728-4 |
| work_keys_str_mv | AT liyouhu thecombinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT jindouji thecombinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT dongli thecombinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT jingmeng thecombinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT boyu thecombinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT liyouhu combinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT jindouji combinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT dongli combinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT jingmeng combinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials AT boyu combinedeffectofvitaminkandcalciumonbonemineraldensityinhumansametaanalysisofrandomizedcontrolledtrials |