Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Registration: The protocol for this meta-analysis was registered at the International Prospective Register of Systematic Reviews (CRD42021251825). The combination of vitamin K and calcium has a positive effect on lumbar BMD and decreases the level of UcOC. Vitamin K and calcium supplementation led to a significant decrease in UcOC (SMD: − 1.71, 95% CI: − 2.45 to − 0.96). The forest plot analysis revealed that vitamin K combined with calcium was associated with a higher lumbar spine BMD compared to controls. ResultsĪ total of 1346 patients from 10 randomized controlled trials were included in the meta-analysis. We performed subgroup analysis, heterogeneity testing, and assessment of publication bias. Our main endpoints were lumbar BMD, femoral neck BMD, hip BMD, total femoral BMD, and UcOC from baseline to end point. The standard mean difference (SMD) was used as the primary measure of effect size. We also reviewed the reference lists of the relevant publications and reviews to locate additional publications. MethodsĪ search for articles was conducted using PubMed, Embase, and the Cochrane Library database up to March 2021 (no language restrictions). We conducted a systematic review of randomized controlled trials to assess the effect of this combination treatment on BMD and UcOC in humans. With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent.

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