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Arthritis & Rheumatism

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Volume 54, Issue 4 , Pages 1255 - 1261

Published Online: 29 Mar 2006

Copyright © 2006 by the American College of Rheumatology

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American College of Rheumatology
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 Research Article
Low vitamin K status is associated with osteoarthritis in the hand and knee
Tuhina Neogi 1 *, Sarah L. Booth 2, Yu Qing Zhang 1, Paul F. Jacques 2, Robert Terkeltaub 3, Piran Aliabadi 4, David T. Felson 1
1Boston University School of Medicine, Boston, Massachusetts
2Tufts University, Boston, Massachusetts
3University of California at San Diego
4Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts
email: Tuhina Neogi (tneogi@bu.edu)

*Correspondence to Tuhina Neogi, Clinical Epidemiology Research and Training Unit, 715 Albany Street, A203, Boston, MA 02118

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the US Department of Agriculture.

Funded by:
 NIH; Grant Number: AG-14759, AR-47785, AG-18393, P01-AGO-7996
 Veterans Administration Research Service
 National Heart, Lung, and Blood Institute (NHLBI) Framingham Heart Study; Grant Number: N01-HC-25195
 US Department of Agriculture; Grant Number: 58-1950-4-401
 Arthritis Foundation Postdoctoral Fellowship Award
 Abbott Scholar Award in Rheumatology


Poor intake of vitamin K is common. Insufficient vitamin K can result in abnormal cartilage and bone mineralization. Furthermore, osteophyte growth, seen in osteoarthritis (OA), may be a vitamin K-dependent process. We undertook this study to determine whether vitamin K deficiency is associated with radiographic features of OA.

We conducted an analysis among 672 participants (mean age 65.6 years, 358 women) in the Framingham Offspring Study, a population-based prospective observational cohort. Levels of plasma phylloquinone (the primary form of vitamin K) had previously been measured in these participants, for whom we also had bilateral hand and knee radiographs. The main outcomes were 1) prevalence ratios (PRs) of OA, osteophytes, and joint space narrowing (JSN) per quartile of plasma phylloquinone level for each joint, adjusting for correlated joints using generalized estimating equations, and 2) adjusted mean number of joints with each feature per quartile of plasma phylloquinone level. Analyses were conducted in hands and knees separately and adjusted for age, sex, body mass index, total energy intake, plasma vitamin D, and femoral neck bone mineral density.

The PRs for OA, osteophytes, and JSN and adjusted mean number of joints with all 3 features in the hand decreased significantly with increasing plasma phylloquinone levels (P 0.03 for all). For example, as plasma phylloquinone levels rose, the PR for hand OA decreased from 1.0 to 0.7 (P = 0.005). For the knee, only the PR for osteophytes and the adjusted mean number of knee joints with osteophytes decreased significantly with increasing plasma phylloquinone levels (PR decreased from 1.0 to 0.6, P = 0.01).

These observational data support the hypothesis of an association between low plasma levels of vitamin K and increased prevalence of OA manifestations in the hand and knee.

Received: 6 September 2005; Accepted: 30 December 2005

Digital Object Identifier (DOI)

10.1002/art.21735  About DOI

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