SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Bone Research
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1703116
This article is part of the Research TopicNatural Products in Bone Health and Disease: Mechanisms, Therapeutics, and Clinical PotentialView all articles
The Effect of Vitamin K2 Supplementation on Bone Turnover Biochemical Markers in Postmenopausal Osteoporosis Patients: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1The Second School of Clinical Medicine , Zhejiang Chinese Medical University, Hangzhou, China
- 2The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Background Osteoporosis is a metabolic bone disease characterized by decreased bone mass and increased fracture risk. Bone turnover markers, such as osteocalcin (OC), undercarboxylated osteocalcin (ucOC), and other biochemical indicators, are important for assessing bone metabolism. Vitamin K2 influences bone metabolism by enhancing osteocalcin γ-carboxylation. Methods This study followed PRISMA guidelines and included randomized controlled trials on the effects of vitamin K2 supplementation on bone turnover biomarkers in postmenopausal osteoporosis patients. Key outcomes included changes in OC, ucOC, and other bone metabolism markers. Results Nine studies with 2,570 participants were included. Vitamin K2 (VK2) increased osteocalcin (OC; MD 1.86, 95% CI 1.17–2.56) and bone-specific alkaline phosphatase (BAP; MD 1.49, 95% CI 0.98– 2.00). It reduced undercarboxylated OC (ucOC; WMD −1.54, 95% CI −2.44 to −0.64) and tartrate-resistant acid phosphatase (TRAP; MD −0.83, 95% CI −1.21 to −0.46). C-terminal telopeptide (CTX) showed a small, statistically significant reduction (MD −0.09, 95% CI −0.14 to −0.05) with uncertain clinical relevance. N-telopeptide (NTX) showed no significant change. Conclusions This is a provisional file, not the final typeset article Vitamin K2 supplementation improves key bone turnover biomarkers, particularly OC and ucOC. These findings support its role in bone metabolism, though further long-term studies are needed to confirm clinical benefits, such as increased bone mineral density.
Keywords: Vitamin K2, Osteoporosis, Bone turnover markers, Meta-analysis, Osteocalcin, ucOC, bone metabolism
Received: 10 Sep 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Zhang, Li, Yuan, Liu and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaolin Shi, xlshi-2002@163.com
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