EMAN RESEARCH PUBLISHING | <p>Evaluation of the Status of Vitamin D3 and Vitamin K2 of Bangladeshi Postmenopausal Women: A Cross-Sectional Study</p>
MicroBio Pharmaceuticals and Pharmacology | Online ISSN 2209-2161

Evaluation of the Status of Vitamin D3 and Vitamin K2 of Bangladeshi Postmenopausal Women: A Cross-Sectional Study

Fatema Akthera*, Asma Rahmanb, Md. Latiful Barib, Md. Ayub Hossenc

+ Author Affiliations

Microbial Bioactives 5(2) 190-197 https://doi.org/10.25163/microbbioacts.525315

Submitted: 04 July 2022  Revised: 29 October 2022  Published: 29 December 2022 


Background: Postmenopause is the name given to the time when a woman stops periodical bleeding for an entire year. In this stage of postmenopause, women remain at increased risk of several health anomalies, such as osteoporosis, diabetes, vision problem, dental problem, and heart disease. Hence, the purpose of the study was to assess the status of vitamin D3 and vitamin K2 [menaquinone-4 (MK-4)] among Bangladeshi postmenopausal women especially those confined to Dhaka city. Methods:  A cross-sectional analytical study was done in the Retired Government Employees Hospital in the year 2019 where 55 postmenopausal women below 60 years were selected. The blood sample was collected from them and the level of serum vitamin D3 [25(OH)D] and vitamin K2 [menaquinone-4 (MK-4)] were determined by the high-performance liquid chromatography (HPLC) method. Binary logistic regression was used for model fitness and its significance. ResultsThe mean ages of the postmenopausal women were 55.80±3.55 years. Their body mass index and waist-hip ratio were 26.03±2.66 kg/m2 and 0.93±0.05 cm, respectively. Serum levels of vitamin D3 [25(OH) D] and menaquinone-4 (MK-4) from postmenopausal women were 14.80±6.36 ng/mL and0.38±0.21 ng/mL, respectively. The regression model used in this study was 74% fit, and diabetes, cardiovascular disease (CVD), dental problems, vision problems, and hearing problems were significant for postmenopausal women. However, serum vitamin D3 and serum vitamin K2 were non-significant at the 5% significance level. A high incidence of insufficient serum vitamin D3 [25(OH) D] level and sufficient serum vitamin K2 (MK-4) level were found among postmenopausal women with pre-obese and high waist-hip ratio (WHR). Conclusion: The level of serum vitamin D3 and K2 and their correlation with BMI, WHR, and overall health status may provide insight to medical professionals and dietitians to take necessary action to address various health issues faced by postmenopausal women.

Keywords: Vitamin D3; Vitamin K2; Postmenopause; Women; Health anomalies.


Adams, J.S., Chen, H. & Chun, R. (2007). Substrate and enzyme trafficking as a means regulating 1,25-dihydroxyvitamin D synthesis and action: the human innate immune response. Journal of Bone and Mineral Research, 22(2), V20-4.                                                                                                                     doi:10.1359/jbmr.07s214

Ahmed, S.A.K.M., Haque, W.M.M., Uddin, K.J. & Abrar, F.A. (2018). Vitamin D and bone mineral density status among postmenopausal Bangladeshi women. IMC Jounal  of Medical  Science, 12(2), 44-49.

Ashrafi, M. & Kazemi, S. (2010). Symptoms of natural menopause among Iranian women living in Tehran, Iran. Journal of Reproductive BioMedicine, 8(1), 29-32.

Beulens, J.W., Booth, S.L., & van, den, Heuvel, E.G. (2013). The role of menaquinones (vitamin K2) in human health. The British Journal of Nutrition, 110(8), 1357–1368.                    doi:10.1017/S0007114513001013

Beulens, J.W., Bots, M.L. & Atsma, F. (2009). High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis, 203(2), 489–493.          doi:10.1016/j.atherosclerosis.2008.07.010

Booth, S.L. & Suttie, J.W. (1998). Dietary intake and adequacy of vitamin K. The Journal of  Nutrition, 128(5),785–788.                                                                                                              doi:10.1093/jn/128.5.785

Cheung, A.M., Tile, L., & Lee, Y. (2008). Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial. PLoS Medicine, 5(12), e196. doi:10.1371/journal.pmed.0050196

Cockayne, S., Adamson, J. & Lanham-New, S. (2006). Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Archives of Internal Medicine, 166(12), 1256–1261.                                                                                                                                               doi:10.1001/archinte.166.12.1256

Ferland, G. (2012). The discovery of vitamin K and its clinical applications. Annals of Nutrition and Metabolism, 61(13), 213-218.                                                                                       doi:10.1159/000343108

Flore, R., Ponziani, F.R. & Rienzo, T.A. (2013). Something more to say about calcium homeostasis: the role of vitamin K2 in vascular calcification and osteoporosis. Europian Review for Medical and Pharmacological Sciences, 17(8), 2433-2440.

Geleijnse, J.M., Vermeer, C. & Grobbee, D.E. (2004). Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the rotterdam study. The Journal of Nutrition, 134(11), 3100–3105.                                                                                                                             doi:10.1093/jn/134.11.3100

Habu, D., Shiomi, S. & Tamori, A. (2004). Role of vitamin K2 in the development of hepatocellular carcinoma in women with viral cirrhosis of the liver. Journal of the American Medical Association, 292(3), 358–361.                                                                                                          doi:10.1001/jama.292.3.358

Hosho, K., Okano, JI. & Koda, M. (2008). Vitamin K2 has no preventive effect on recurrence of hepatocellular carcinoma after effective treatment. Yonago Acta Medica, 51(4), 95–99.

Hotta, N., Ayada, M. & Sato, K. (2007). Effect of vitamin K2 on the recurrence in patients with hepatocellular carcinoma. Hepato-gastroenterology, 54(79), 2073–2077.

Kakizaki, S., Sohara, N. & Sato, K. (2007). Preventive effects of vitamin K on recurrent disease in patients with hepatocellular carcinoma arising from hepatitis C viral infection. Journal of Gastroenterology and Hepatology, 22(4), 518–522.                                                             doi:10.1111/j.1440-1746.2007.04844.x

Kamao, M., Suhara, Y., Tsugawa, N. & Okano, T. (2005). Determination of plasma vitamin-K by high-performance liquid chromatography with fluorescence detection using vitamin K analogs as internal standards. Journal of Chromatography B, 816(1-2), 41-48.                                                                     doi:10.1016/j.jchromb.2004.11.003

Klapkova, E., Cepova, J., Dunovska, K. & Prusa, R. (2018). Determination of vitamins K1, MK-4, and MK-7 in human serum of postmenopausal women by HPLC with fluorescence detection. Journal of Clinical Laboratory Analysis, 32(5), e22381.                                                                                      doi:10.1002/jcla.22381

Knapen, M.H., Braam, L.A., Teunissen, K.J., Zwijsen, R.M., Theuwissen, E. & Vermeer, C. (2015). Yogurt drink fortified with menaquinone-7 improves vitamin K status in a healthy population. Journal of Nutritional Science, 16(4), e35.                                                                                                                      doi:10.1017/jns.2015.25

Knapen, M.H., Schurgers, L.J. & Vermeer, C. (2007). Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporosis International, 18(7), 963–972.                                                                                                                                                                                       doi:10.1007/s00198-007-0337-9

Kojima, K., Tamano, M. & Akima, T. (2010). Effect of vitamin K2 on the development of hepatocellular carcinoma in type C cirrhosis. Hepato-gastroenterology, 57(102-103), 1264–1277.

Krueger, T., Westenfeld, R. & Schurgers, L. (2009). Coagulation meets calcification: the vitamin K system. The International Journal of Artificial Organs, 32(2), 67–74.                                                      doi:10.1177/039139880903200202

Maresz, K. (2015). Proper calcium use: vitamin K2 as a promoter of bone and cardiovascular health. Integrative Medicine: A Clinician's Journal, 14(1), 34-39.

Mizuta, T., Ozaki, I. & Eguchi, Y. (2006). The effect of menatetrenone, a vitamin K2 analog, on disease recurrence and survival in patients with hepatocellular carcinoma after curative treatment: a pilot study. Cancer, 106(4), 867–782.                                                                                                    doi:10.1002/cncr.21667

Okano, T., Shimomura, Y. & Yamane, M. (2008). Conversion of phylloquinone (vitamin-K1) into menaquinone-4 (vitamin K2) in mice: two possible routes for menaquinone-4 accumulation in cerebra of mice. The Journal of Biological Chemistry, 283(17), 11270-11279.                                                            doi: 10.1074/jbc.M702971200

Park, J.N., Lee, J.S., Noh, M.Y. & Sung, M.K. (2015). Association between usual vitamin K intake and anticoagulation in patients under warfarin therapy. Clinical Nutrition Research, 4(4), 235-241.                            doi: 10.7762/cnr.2015.4.4.235

Paul, T.V., Thomas, N., Seshadri, M.S., Oommen, R., Jose, A. & Mahendri, N.V. (2008). Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin D status. Endocrine Practice, 14(6), 665-671.                           doi: 10.4158/EP.14.6.665

Tariq, S., Roohi, S., Zahoor, R., Iqbal, Z., &  Haider, I. (2012). Development of vitamin D3 HPLC method and its application in blood serum analysis of workers of radiation area. Journal of Liquid Chromatography & Related Technologies, 35(19), 2765-2776. doi:10.1080/10826076.2011.639113

Sandhu, S.K. & Hampson, G. (2011). The pathogenesis, diagnosis, investigation and management of osteoporosis. Journal of Clinical Pathology, 64(12), 1042-1050.                                                              doi:10.1136/jcp.2010.077842

Schurgers, L.J., Cranenburg, E.C. & Vermeer, C. (2008). Matrix Gla-protein: The calcification inhibitor in need of vitamin K. Thrombosis and Haemostasis, 100(4), 593–603.                                             doi:10.1160/TH08-02-0087

Tsugawa, N. (2015). Cardiovascular diseases and fat soluble vitamins: vitamin D and vitamin K. Journal of Nutritional Science and Vitaminology, 61, S170-S172.                                                doi:10.3177/jnsv.61.S170

Tsugawa, N., Shiraki, M., Suhara, Y., Kamao, M., Tahala, K. & Okano, T. (2006). Vitamin K status of healthy Japanese women: age-related vitamin K requirement for gamma-carboxylation of osteocalcin. The American Journal of Clinical Nutrition, 83(2), 380-386.                                               doi:10.1093/ajcn/83.2.380

Viljakainen, H.T., Saarnio, E. & Hytinantti, T. (2010). Maternal vitamin D status determines bone variables in the newborn. The Journal of Clinical Endocrinology and Metabolism, 95(4), 1749-1757.  doi:10.1210/jc.2009-1391

World Health Organization. (2005). Public health action for healthier healthy women: population based study. Iranian Journal of Public Health, ISBN 92-890-1376-1.

Yoshida, H., Shiratori, Y. & Kudo, M. (2011). Effect of vitamin K2 on the recurrence of hepatocellular carcinoma. Hepatology, 54(2), 532–540.                                                                              doi:10.1002/hep.24430

Yoshida, M., Jacques, P.F. & Meigs, J.B. (2008). Effect of vitamin K supplementation on insulin resistance in older men and women. Diabetes Care, 31(11), 2092–6.                                  doi:10.2337/dc08-1204

Yoshiji, H., Noguchi, R. & Toyohara, M. (2009). Combination of vitamin K2 and angiotensin converting enzyme inhibitor ameliorates cumulative recurrence of hepatocellular carcinoma. Journal of Hepatology, 51(2), 315–321.                                                                                                                 doi:10.1016/j.jhep.2009.04.011

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