Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women

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Abstract
Background: Vitamin K has been associated with bone mineral density (BMD) and risk of hip fracture. The apolipoprotein (apo) E4 allele (APOE*E4) has been associated with bone fracture through a putative effect on vitamin K transport in blood. Objective: The objective was to determine the associations between vitamin K intake, apo E genotype, BMD, and hip fracture in a population-based cohort of elderly men and women. Design: Dietary vitamin K intake was assessed with a food-frequency questionnaire in 335 men and 553 women (average age: 75.2 y) participating in the Framingham Heart Study in 1988–1989. Incidence of hip fractures was recorded from 1988 to 1995. BMD at the hip, spine, and arm was assessed on 2 separate occasions (1988–1989 and 1992–1993). Comparisons between apo E genotype and BMD were made relative to E4 allele status (at least 1 ϵ4 allele compared with no ϵ4 allele). Results: Individuals in the highest quartile of vitamin K intake (median: 254 μg/d) had a significantly lower fully adjusted relative risk (0.35; 95% CI: 0.13, 0.94) of hip fracture than did those in the lowest quartile of intake (median: 56 μg/d). There were no associations between vitamin K intake and BMD in either men or women. No association was found between the E4 allele and BMD, and there were no significant interactions between the E4 allele and phylloquinone intake and BMD or hip fracture. Conclusions: Low vitamin K intakes were associated with an increased incidence of hip fractures in this cohort of elderly men and women. Neither low vitamin K intake nor E4 allele status was associated with low BMD.