Poster Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

Dietary vitamin K1 intake and long-term fracture-hospitalisation risk in older Australian women: the Perth Longitudinal Study of Ageing Women (#129)

Marc Sim 1 2 , Joshua R Lewis 1 2 3 , Lauren C Blekkenhorst 1 2 , Jonathan M Hodgson 1 2 , Richard L Prince 4 5
  1. School of Medical & Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
  2. Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia
  3. Centre for Kidney Research, Children's Hospital at Westmead, The University of Sydney, Sydney, New South Wales, Australia
  4. Medical School, Sir Charles Gardner Unit, The University Western Australia, Perth, Western Australia, Australia
  5. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

Aims: Vitamin K sufficiency has been linked to better musculoskeletal health. The majority of vitamin K intake comes from vegetables in the form of K1. We previously demonstrated an inverse association between intake of cruciferous vegetables, a good source of K1, and fracture-related hospitalisations (1). We aimed to examine the association of dietary K1 intake with bone structure and fracture-related hospitalisations over 14.5 years in the Perth Longitudinal Study of Ageing Women, a prospective cohort study of older Australian women (n=1429, ≥ 70 years).

Methods: Vitamin K1 intake at baseline (1998) was estimated using a validated food frequency questionnaire and the USDA National Nutrient Database.  Hip and heel bone were measured using dual x-ray absorptiometry and quantitative ultrasonography (speed of sound [SOS] and broadband ultrasound attenuation [BUA]), respectively. Total fracture (n=404, 28.3%) and hip fracture (n=153, 10.7%) hospitalisations over 14.5 years were captured using linked health records.

Results: Kaplan-Meier curves for quartiles of vitamin K1 intake with any fracture and hip fracture-related hospitalisations are presented in Figure 1. In multivariable-adjusted Cox regression models, women with the highest vitamin K1 intake (Quartile 4, ≥118 ug/d) had lower hazards for any fracture (HR 0.55 95%CI 0.41-0.45, p<0.001) and hip-fracture related hospitalisation (HR 0.37 95%CI 0.21-0.65, p<0.001) compared to women with the lowest vitamin K1 intake (Quartile 1, <68 ug/d). Multivariable-adjusted generalised linear models showed women with the highest vitamin K1 intake had higher hip BMD (mean difference [MD] 0.033 95%CI 0.006-0.060, p=0.006) and faster SOS (MD 5.73 95%CI 0.35-11.10, p=0.030) compared to women with the lowest vitamin K1 intake.

Conclusion: These data identify a substantial reduction in fracture risk and beneficial effects on bone structure in those participants with high baseline intakes of vitamin K1.

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  1. 1. Blekkenhorst LC, Hodgson JM, Lewis JR, Devine A, Woodman RJ, Lim WH, Wong G, Zhu K, Bondonno CP, Ward NC, Prince RL (2017) Vegetable and fruit intake and fracture-related hospitalisations: a prospective study of older women. Nutrients 9:E511