BACKGROUND Previous studies did not draw a consistent conclusion about the effects of vitamin K combined with vitamin D on human skeletal quality. METHOD AND FINDINGS A comprehensive search on Web of Science, PubMed, Embase and the Cochrane Library (from 1950 to February 2020) and bibliographies of relevant articles was undertaken, with the meta-analysis of eight randomized controlled trials (RCTs) including a total of 971 subjects. Vitamin K combined with vitamin D significantly increased the total bone mineral density (BMD): the pooled effect size was 0.316 [95% CI (confidence interval), 0.031 to 0.601]. A significant decrease in undercarboxylated osteocalcin (-0.945, -1.113 to -0.778) can be observed with the combination of vitamin K and D. Simultaneously, subgroup analysis showed that K2 or vitamin K (not specified) supplement was less than 500 μg d-1, which when combined with vitamin D can significantly increase the total BMD compared with the control group fed a normal diet or the group with no treatment (0.479, 0.101 to 0.858 and 0.570, 0.196 to 0.945). CONCLUSIONS The combination of vitamin K and D can significantly increase the total BMD and significantly decrease undercarboxylated osteocalcin, and a more favorable effect is expected when vitamin K2 is used.

中文翻译：

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维生素K和维生素D对人体骨骼质量的联合作用：一项随机对照试验的荟萃分析。

背景技术先前的研究并未就维生素K与维生素D结合对人体骨骼质量的影响得出一致的结论。方法和研究结果对Web of Science，PubMed，Embase和Cochrane图书馆（1950年至2020年2月）和相关文献的参考书目进行了全面搜索，并对8项随机对照试验（RCT）进行了荟萃分析，其中包括971个科目。维生素K与维生素D的结合显着增加了总骨矿物质密度（BMD）：合并效应量为0.316 [95％CI（置信区间），为0.031至0.601]。维生素K和D的组合可观察到羧化骨钙素不足的明显减少（-0.945，-1.113至-0.778）。亚组分析显示，补充维生素K2或维生素K（未指定）的d-1少于500μgd-1，与常规饮食或未经治疗的对照组相比，与维生素D结合使用可显着增加总BMD。 0.479、0.101至0.858和0.570、0.196至0.945）。结论维生素K和D的组合可以显着增加BMD的总量，并显着降低羧化骨钙素的不足，使用维生素K2有望获得更好的效果。