Effect of vitamin K2 supplementation on vertebral fracture risk inpostmenopausal osteoporosis: a systematic review and meta-analysis
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Abstract
Vitamin K2 has been proposed as a potential modulator of bone metabolism because of its role in osteocalcin γ-carboxylation. However, its effect on fracture risk in postmenopausal women with osteoporosis remains uncertain. Materials and methods: we conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of vitamin K2 on vertebral fractures in postmenopausal women with osteoporosis. Search was performed in PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL). Two reviewers independently screened studies, extracted data, and assessed risk of bias using the RoB 2 tool. Eligible studies compared vitamin K2 versus control, or vitamin K2 added to the same background therapy in both groups. The primary outcome was incident vertebral fracture. Quantitative synthesis was performed using a random-effects model and expressed as risk ratio (RR) with 95% confidence interval (95% CI). Results: a total of 46 records were identified, and 2 randomized controlled trials met the criteria for quantitative synthesis. Meta-analysis showed that vitamin K2 supplementation did not significantly reduce vertebral fracture risk compared with control (RR 1.04; 95% CI 0.87-1.23). No statistical heterogeneity was observed across studies (I²=0.0%). Conclusion: available evidence does not demonstrate a significant effect of vitamin K2 in reducing vertebral fracture risk in postmenopausal women with osteoporosis. However, further studies with larger sample sizes and higher methodological quality are needed to better define its clinical role.
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