Summary Vitamin K may affect  bone mineral density and fracture incidence .
Since publication of a previous systematic review the integrity of some of the previous evidence has been question ed and further trials have been published .
Introduction This systematic review was design ed to assess the effectiveness of oral vitamin K supplementation for increasing bone mineral density  and reducing fractures in adults .
Multidetector-row computed tomography is useful to evaluate the therapeutic effects of bisphosphonates in glucocorticoid-induced osteoporosis
Osteoporosis is one of the major complications of glucocorticoid therapy . Osteoporosis is usually defined by the levels of bone mineral density ( BMD ) assessed by dual energy X-ray absorptiometry ( DEXA ) ; however , glucocorticoids often induce fractures in patients with normal BMD . Thus , novel diagnostic approaches are required . In this study , we examined whether multidetector-row computed tomography ( MDCT ) is useful to assess the bone status in glucocorticoid-induced osteoporosis ( GIO ) . Because bisphosphonates have been proven to prevent bone fracture in GIO , we tried to detect the therapeutic effects of bisphosphonates in GIO by MDCT . Fifteen Japanese patients with immunoglobulin A nephropathy who had normal renal function were enrolled in this open-label r and omized trial . Patients were r and omly divided into three groups — calcitriol ( VD ) , menatetrenone ( VK ) , or bisphosphonate ( Bis ) . Bone conditions were analyzed twice by three different methods —bone turnover markers , DEXA , and MDCT — at the start and 6 months after the start of therapy . Both bone markers and DEXA could not detect significant differences among the therapeutic groups ; however , MDCT-based analyses detected the preventive effects of bisphosphonates in GIO . Compared to VD , Bis improved structural indices , such as bone volume fraction , trabecular separation , marrow star volume , and structure model index whereas the difference between VD and VK was not significant . Finite element analysis revealed that simulated fracture load in the Bis group was significantly improved . These findings suggested that MDCT-based assessment is superior to bone markers and /or DEXA in assessing the therapeutic effect of bisphosphonates on GIO
Summary Vitamin K may affect  bone mineral density and fracture incidence .
Since publication of a previous systematic review the integrity of some of the previous evidence has been question ed and further trials have been published .
Introduction This systematic review was design ed to assess the effectiveness of oral vitamin K supplementation for increasing bone mineral density  and reducing fractures in adults .