Vitamin K and its influence on the joints: a deep analysis of the mechanisms, clinical data and dietary strategies. The introduction (excluded according to the conditions of the problem) vitamin K, a group of fat -soluble vitamins is traditionally known for its key role in blood coagulation (coagulation). However, in recent years, more and more attention has been paid to its significance in other physiological processes, especially in maintaining the health of bones and, therefore, joints. This article is a detailed review of the effect of vitamin K on the health of the joints, considering its biochemical mechanisms, clinical evidence and dietary correction strategies to ensure the optimal status of vitamin K. 1. Vitamin K biochemistry: forms, metabolism and vitamin K function is not a single compound, but is a group of structurally similar naphthokhinons. The main forms of vitamin K include: * vitamin K1 (phyllokhinon): the main form of vitamin K contained in green leafy vegetables and some vegetable oils. Fillokhinon is the main dietary source of vitamin K. * vitamin K2 (menachinons): it is synthesized by bacteria in the intestines and is found in enzyme products such as NATTO (fermented soybeans). Menikhinons exist in various forms (MK-4, MK-7, MK-9, etc.), which differ in the length of the isopreline lateral chain. The MK-7 has a longer half-life and higher bioavailability than the MK-4. * Vitamin K3 (Menadion): The synthetic form of vitamin K, which is not contained in nature and requires alkylation for activity. It is less preferable for oral administration due to potential toxicity. Vitamin K metabolism: Vitamin K, being fat -soluble vitamin, is absorbed in the small intestine in the presence of bile acids and pancreatic enzymes. Fillokhinon is predominantly absorbed in the proximal section of the small intestine, and menachinons in distal. After absorption, vitamin K is transferred to the liver in chilomicrons. In the liver, vitamin K is included in very low density lipoproteins (VLDL) and is released into the blood. Vitamin K stocks in the liver in small quantities. The main function of vitamin K is associated with gamma carboxylation of the remains of glutamate in certain proteins, turning them into gamma-carboxiglutamate (GLA). This process is necessary to activate vitamin K-dependent proteins that play an important role in various physiological processes, including blood coagulation, bone metabolism and vascular calcification. Vitamin K-dependent proteins: * blood coagulation factors (factors II, VII, IX, X): are necessary for the cascade of blood coagulation. Varfarin and other anticoagulants block vitamin K-epoxydredaz, the enzyme necessary for the regeneration of the active form of vitamin K, thereby inhibiting the synthesis of active blood coagulation factors. * Osteokalcin: synthesized by osteoblasts and is the main non -allagen protein of bone matrix. Gamma carboxylation of osteocalcin is necessary to bind it to hydroxyapatitis, a mineral component of the bone, which contributes to the mineralization of bones. * Matrix GLA (MGP): powerful vascular calcification inhibitor. Gamma carboxylation of MGP is necessary for its activity in preventing calcium deposition in soft tissues, including arteries and cartilage. * Perostin: plays a role in the formation of bones and maintaining the integrity of the ligaments. * Squirrel S: Anticoagulant protein, which enhances the action of protein C. 2. The role of vitamin K in the metabolism of bones and cartilage vitamin K plays a critical role in bone metabolism, affecting both osteoblasts and resorption of osteoclasts bones. The main mechanism of action of vitamin K in the bones is associated with the activation of osteocalcine. Gamma-carboxylated osteocalcin is associated with hydroxyapatitis, contributing to the mineralization of bones and an increase in bone density. The lack of vitamin K leads to a decrease in osteocalcin carboxylation, which weakens the bones and increases the risk of fractures. In addition, vitamin K affects the metabolism of bones through other mechanisms, including: * regulation of osteoclast activity: some studies show that vitamin K can inhibit the formation and activity of osteoclasts, cells responsible for bone resource. * Influence on the signaling paths: Vitamin K can modulate various signaling paths involved in bone metabolism, such as the WNT-signal path. * Interaction with other vitamins and minerals: vitamin K interacts with other nutrients, such as vitamin D, calcium and magnesium, to maintain bone health. Vitamin D promotes calcium absorption, and vitamin K helps to direct calcium into the bone, preventing its deposition in soft tissues. With regard to cartilage, studies have shown that vitamin K can play a role in maintaining the integrity of cartilage and preventing its degradation. The matrix GLA-beam (MGP) plays an important role in preventing cartilage calcification. The disadvantage of vitamin K leads to a decrease in MGP carboxylation, which helps to deposit calcium in cartilage and can lead to the development of osteoarthritis. In addition, vitamin K can have anti -inflammatory properties that can help protect cartilage from damage caused by inflammation. 3. Vitamin K and osteoarthritis: epidemiological and clinical data of osteoarthritis (OA) is the most common joint disease characterized by cartilage degradation, inflammation and pain. Epidemiological studies have shown the relationship between a low level of vitamin K and an increased risk of OA development. * Studies evaluating the relationship between vitamin K consumption and the risk of OA showed conflicting results. Some studies have found that higher consumption of vitamin K is associated with a reduced risk of OA, especially the OA of the knee joint. Other studies have not revealed a significant connection. * Studies that evaluate the level of vitamin K in the blood and the risk of OA have also shown conflicting results. Some studies have found that the low level of vitamin K in the blood is associated with an increased risk of OA, while other studies did not reveal a significant connection. Clinical studies that evaluate the effects of vitamin K on the symptoms of OA also showed ambiguous results. * Some studies have shown that vitamin K additives can reduce pain and improve joint function in patients with OA. * Other studies did not reveal the significant effect of vitamin K additives on the symptoms of OA. The ambiguous research results can be associated with various factors, including: * various forms of vitamin K: different forms of vitamin K (K1, K2, MK-4, MK-7) can have different effects on joint health. * Different doses of vitamin K: The optimal dose of vitamin K to maintain joint health can vary depending on individual factors. * Different populations of patients: the effect of vitamin K on OA can vary depending on age, gender, ethnicity and other factors. * Duration of research: the duration of research can affect the results. Despite the contradictory results, most studies indicate that maintaining the adequate status of vitamin K can be useful for the health of the joints and the prevention of OA. Further research is needed to determine the optimal form and dose of vitamin K for the prevention and treatment of OA. 4. Vitamin K and rheumatoid arthritis: potential mechanisms and clinical data of rheumatoid arthritis (RA) are a chronic autoimmune disease characterized by inflammation of the joints, the destruction of cartilage and bones. Unlike osteoarthritis, rheumatoid arthritis has an autoimmune nature, where the immune system attacks its own joint tissue. The role of vitamin K in RA is less studied than in the OA, but there are several potential mechanisms through which vitamin K can influence this disease. * Anti -inflammatory properties: Vitamin K can have anti -inflammatory properties that can help reduce inflammation in the joints in patients with RA. Some studies have shown that vitamin K can inhibit the development of pro-inflammatory cytokines, such as Interleukin-1 (IL-1) and Alpha necrosis factor (TNF-α). * Influence on osteoclasts: Vitamin K can inhibit the activity of osteoclasts, cells responsible for bone resorption. Osteoclasts play a role in the destruction of bones around the joints. * Antioxidant activity: Vitamin K can have antioxidant activity, which can help protect the joints from damage caused by free radicals. Clinical data on the influence of vitamin K on RA are limited. * Several small studies have shown that vitamin K additives can reduce pain and inflammation in patients with RA. * Other studies did not reveal the significant effect of vitamin K additives on the symptoms of RA. Further studies are needed to determine the role of vitamin K in RA and to assess the effectiveness of vitamin K additives in the treatment of this disease. It is important to note that RA is a complex disease, and treatment should be complex, including drug therapy, physiotherapy and a change in lifestyle. Vitamin K can be considered as an auxiliary remedy in the complex treatment of RA. 5. Vitamin K and other joint diseases: gout, ankylosing spondylitis and other effects of vitamin K on other joint diseases, such as gout and ankylosing spondylitis, is not understood enough. * Gout: a disease caused by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. There are no direct studies that evaluate the influence of vitamin to gout. However, given the potential anti -inflammatory properties of vitamin K, it can be assumed that it can have some positive effect on a decrease in inflammation with gout. Further research is needed. * Ankylosing spondylitis: chronic inflammatory disease that affects the spine and other joints. There is no sufficient data to conclude about the effect of vitamin K on ankylosing spondylitis. Given the possible role of vitamin K in bone metabolism and potential anti -inflammatory properties, additional studies are required to assess its effect on this disease. In general, studies on the effect of vitamin K on joint diseases, different from OA and RA, are limited. Further studies are needed to determine the role of vitamin K in the pathogenesis and the treatment of these diseases. 6. Diagnosis of vitamin K deficiency K assessment of vitamin K status can be a complex task, since the direct measurement of vitamin K in the blood does not always reflect its functional activity. The most common methods for assessing the status of vitamin K include: * measurement of phillokhinon in plasma: reflects the recent consumption of vitamin K1. Various factors, such as diet and medication, can affect the level of phyllokhinon in plasma. * Measurement of non -carboxilized osteocalcin (UCOC): Nonerboxylated osteokalcin is a marker of vitamin K deficiency, a high level of UCOC indicates a lack of vitamin K and a decrease in bone mineralization. * Measurement of a non -arboxylated matrix GLA-protein (UCMGP): a non-carboxilized MGP is a marker of vitamin K deficiency and increased risk of vessel calcification. * Test for blood coagulation (prothrombin time): Protrombin time (PTV) is a measure of time required for blood coagulation. An increase in the PTV may indicate a deficiency of vitamin K, but can also be caused by other factors. Vitamin K deficiency is often found in people with malabsorption of fats, liver diseases taking anticoagulants (warfarin), as well as in newborns. Symptoms of vitamin K deficiency may include: * easy formation of bruises and bleeding. * Bleeding from the nose or gums. * Blood in the urine or feces. * Abundant menstrual bleeding. * Osteoporosis and increased risk of fractures. * Calcification of blood vessels. 7. Dietary sources of vitamin K optimal consumption of vitamin K is important for maintaining bone and joint health. The main dietary sources of vitamin K include: * green leafy vegetables: spinach, kale cabbage, broccoli, brass salad, parsley. Green leaf vegetables are a rich source of vitamin K1 (phyllokhinon). * Some fruits: avocado, kiwi, grapes. * Vegetable oils: soy oil, rapeseed oil, olive oil. * Enzymes: NATTO (fermented soybeans) is a particularly rich source of vitamin K2 (menachinons, especially MK-7). * Animal products: meat, poultry, eggs, dairy products contain a small amount of vitamin K2. The recommended daily (RSN) of vitamin K varies depending on age, gender and other factors. Adults are usually recommended to consume 90-120 μg of vitamin K per day. 8. Vitamin K additives: forms, dosages and safety of vitamin K additives are available in various forms, including vitamin K1 (phyllokhinon) and vitamin K2 (menachinones, especially MK-4 and MK-7). * Vitamin K1 (Phillokhinon): The most common form of vitamin K in addition. It is well absorbed, but has a shorter half -life than vitamin K2. * Vitamin K2 (menachinons): MK-4 and MK-7 are the most common forms of vitamin K2 in addition. The MK-7 has a longer half-life and higher bioavailability than the MK-4, which makes it more preferable to maintain a stable level of vitamin K in the blood. The dosage of vitamin K additives varies depending on individual needs and goals. Usually recommended doses are from 50 to 200 mcg per day. Higher doses can be recommended in certain cases, for example, with vitamin K deficiency or for the treatment of osteoporosis. Vitamin K is usually considered safe when taking recommended doses. However, in people taking anticoagulants (warfarin), taking vitamin K additives can affect the effectiveness of these drugs. It is important to consult a doctor before taking vitamin K additives, especially if you take any medicine. 9. The interaction of vitamin K with other drugs and nutrients vitamin K can interact with other drugs and nutrients. * Anticoagulants (warfarin): Vitamin K is a warfarin antagonist. Reception of vitamin K additives can reduce the effectiveness of warfarin and increase the risk of blood clots. People taking warfarin need to maintain a constant level of consumption of vitamin K from a diet and avoid sharp changes in the consumption of vitamin K. * antibiotics: some antibiotics can kill bacteria in the intestines that synthesize vitamin K2, which can lead to a deficiency of vitamin K. * Orlistat: a medicine for losing weight, which blocks the absorption of fats, can also reduce absorption of absorption of absorption of absorption. fat -soluble vitamins, including vitamin K. * vitamin D: vitamin D and vitamin K work synergistic to maintain bone health. Vitamin D promotes calcium absorption, and vitamin K helps to direct calcium into the bone, preventing its deposition in soft tissues. * Calcium: Calcium is necessary for the health of bones. Vitamin K helps optimize the use of calcium in the body. * Magnesium: Magnesium also plays a role in bone metabolism and can interact with vitamin K. 10. The future directions of vitamin K studies and joints, despite progress in understanding the role of vitamin K in the health of bones and joints, requires further research for: * determining the optimal form and dose of vitamin K for the prevention and treatment of joint diseases. * Studying the mechanisms of action of vitamin K in the cartilage and other joints of the joints. * Conducting large clinical studies to assess the effectiveness of vitamin K additives in the treatment of OA, RA and other joint diseases. * Studying the interaction of vitamin K with other nutrients and drugs in the context of joint health. * Development of new methods for assessing the status of vitamin K, which more accurately reflect its functional activity. Studies in the future should take into account various forms of vitamin K (K1, K2, MK-4, MK-7), different doses and duration of research, as well as take into account individual factors, such as age, gender, ethnicity and the presence of concomitant diseases. Conclusion (excluded according to the conditions of the problem)