{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:32:07Z","timestamp":1775183527665,"version":"3.50.1"},"reference-count":64,"publisher":"IMR Press","issue":"1-2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal for Vitamin and Nutrition Research"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p> Abstract. Low concentrations of serum vitamin K accompany high concentrations of undercarboxylated osteocalcin (ucOC) and osteoporotic fractures. Although vitamin K2 (MK-4) is approved as a therapeutic agent for the treatment of osteoporosis in some countries, the dose-response is unknown. The objective of this study was to assess the improvement in carboxylation of osteocalcin (OC) in response to escalating doses of MK-4 supplementation. A nine-week, open-labeled, prospective cohort study was conducted in 29 postmenopausal women who suffered hip or vertebral compression fractures. Participants took low-dose MK-4 (0.5\u00a0mg) for 3 weeks (until the second visit), then medium-dose MK-4 (5\u00a0mg) for 3 weeks (until the third visit), then high-dose MK-4 (45\u00a0mg) for 3 weeks. The mean\u00a0\u00b1\u00a0 SD age of the participants was 69\u00a0\u00b1\u00a09\u00a0years. MK-4 dose (p\u00a0&lt;\u00a00.0001), but neither age nor other relevant medications (e.g. bisphosphonates) correlated with improvement in %ucOC. As compared to baseline concentrations (geometric mean\u00a0\u00b1\u00a0 SD) of 16.8\u00a0\u00b1\u00a02.4, 0.5\u00a0mg supplementation halved %ucOC to 8.7\u00a0\u00b1\u00a02.2 (p\u00a0&lt;\u00a00.0001) and the 5-mg dose halved %ucOC again (to 3.9\u00a0\u00b1\u00a02.2; p\u00a0=\u00a00.0002 compared to 0.5-mg dose). However, compared to 5\u00a0mg\/day, there was no additional benefit of 45\u00a0mg\/day (%ucOC 4.6; p\u00a0=\u00a0NS vs. 5-mg dose). MK-4 supplementation resulted in borderline increases in \u03b3-carboxylated osteocalcin (glaOC; p\u00a0=\u00a00.07). There were no major side effects of MK-4 supplementation. In postmenopausal women with osteoporotic fractures, supplementation with either 5 or 45\u00a0mg\/day of MK-4 reduces ucOC to concentrations typical of healthy, pre-menopausal women. <\/jats:p>","DOI":"10.1024\/0300-9831\/a000554","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T16:00:34Z","timestamp":1551369634000},"page":"42-48","source":"Crossref","is-referenced-by-count":10,"title":["Maximal dose-response of vitamin-K2 (menaquinone-4) on undercarboxylated osteocalcin in women with osteoporosis"],"prefix":"10.31083","volume":"90","author":[{"given":"Tusar","family":"K Giri","sequence":"first","affiliation":[{"name":"Department of Medicine, Washington University in Saint Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Newton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University in Saint Louis, Missouri"},{"name":"Cleveland Clinic, Cleveland, 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