Kids with Low Vitamin K2 Status at Greater Risk for Fracture

A new study has been presented at the International Conference on Children’s Bone Health in Würzburg, Germany highlighting the increased risk of fracture risk in children with low Vitamin K2 status. While Vitamin D has an established role in the prevention of fractures, this is the first study to evaluate both D and K2 status in healthy children with low-energy fractures (i.e., the result of falling from standing height or less) and in the control group without fractures.

The authors write: “Bone fractures are very common in children and their number is growing every year. Vitamin D has a proven role in the prevention of fractures… [but the] past decade has seen increased interest in the role of Vitamin K, especially K2 menaquinone-7, in bone health and prevention of bone fractures. There is a scarcity of research examining the effects of vitamin K deficiency on bone health in children and adolescent populations. The aim of the current study was to evaluate the Vitamin D and K status in healthy children with low-energy fractures and in the control group without fractures.”

The study group of 20 children aged 5 to 15 years old, with clinically confirmed low-energy fractures was compared with the control group of 19 healthy children, aged 7 to 17 years old, without fractures. Total vitamin D [25(OH)D3 plus 25(OH)D2], calcium, BALP (bone alkaline phosphatase), NTx (N-terminal telopeptide) and undercarboxylated (ucOC) and carboxylated osteocalcin (cOC) serum concentrations were evaluated in every patient. Ratio of serum undercarboxylated osteocalcin to serum carboxylated osteocalcin ucOC:cOC – UCR –  was used as an indicator of vitamin K status. Logistic regression models were created to establish UCR influence for odds ratio of low-energy fractures in both groups.

The study results revealed there were no statistically significant differences in the serum calcium, NTx, BALP or vitamin D levels between the groups; however, the statistically significant difference in the UCR was observed. The median UCR in the fracture group was 0.4709 compared with the control group value of 0.2445 (p<0.000004). In the logistic regression analysis, the odds ratio of fracture for UCR were calculated. Increase of the UCR by 0.1 increases the risk of fracture by 9.62 times (p=0.003).

“Children with bone fractures have two times lower vitamin K status expressed by UCR than healthy controls,” the authors wrote. “Increase of the UCR by 0.1 increases the risk of fracture by 9.62 times (p=0.003).

“The better vitamin K status expressed as the ratio of ucOC: cOC – UCR – have positively and statistically significantly correlated with lower rate of low-energy fracture incidence,” the authors concluded.

“This is a significant study as it supports the strong clinical evidence already in place that revealed that children have the most pronounced K deficiency, making them most in need for K2 supplementation,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. “There is further research in healthy children that shows just 45mcg daily of K2 improves K status and increases the activation of osteocalcin, the K-dependent protein responsible for binding calcium to the bone mineral matrix, therefore improving bone health.”


Karpiński M. Dept. of Pediatric Orthopedics, Medical University of Białystok , Białystok, Poland. Presented at International Conference on Children’s Bone Health, Würzburg, Germany. June 2017. 


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