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Research Article

Low vitamin K status is associated with osteoarthritis in the hand and knee

Tuhina Neogi^{1 *}, Sarah L. Booth², Yu Qing Zhang¹, Paul F. Jacques², Robert Terkeltaub³, Piran Aliabadi⁴, David T. Felson¹

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

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusion

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