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Review
. 2025 Jun 17;13(6):e70431.
doi: 10.1002/fsn3.70431. eCollection 2025 Jun.

Vitamin K: Metabolism, Genetic Influences, and Chronic Disease Outcomes

Montana Dupuy  1 , Nicola P Bondonno  1   2 , Pratik Pokharel  1   2 , Allan Linneberg  3   4 , Itamar Levinger  5 , Carl Schultz  6   7 , Jonathan M Hodgson  1   7   8 , Marc Sim  1   7   8
Affiliations
Review

Vitamin K: Metabolism, Genetic Influences, and Chronic Disease Outcomes

Montana Dupuy et al. Food Sci Nutr. .

Abstract

Vitamin K refers to a group of lipid-soluble vitamins that exist in two natural isoforms; phylloquinone (PK, vitamin K1) and menaquinones (MKs, vitamin K2). Phylloquinone, the primary dietary source, is found abundantly in green vegetables and plant oils. Menaquinones (MK-4 through MK-13) are synthesized by anaerobic bacteria and may be obtained through the diet from fermented foods and animal products (e.g., meats, dairy and eggs). Originally recognized for its role in blood coagulation, vitamin K is an essential cofactor for the posttranslational carboxylation of vitamin K-dependent proteins (VKDPs), which are implicated in various physiological processes including; blood coagulation, calcium homeostasis, as well as metabolic and inflammatory pathways. Therefore, vitamin K has attracted considerable research interest for its potential implications in several diseases. While promising, the specific roles of vitamin K in various health conditions, the quantity of vitamin K (both PK and MKs) required for the function of various VKDPs, and the influence of genetics on vitamin K metabolism, remain unclear. This review aims to (i) provide an overview of the structure, dietary sources, metabolism, and physiological roles of vitamin K, including those relating to; cardiovascular diseases, type 2 diabetes, respiratory conditions, musculoskeletal health and cancer; (ii) discuss the impact of genetic factors on vitamin K status and how such factors modulate the role of vitamin K in the aforementioned chronic diseases; and (iii) outline key directions for future research.

Keywords: bone health; cancer; cardiovascular disease; diabetes; vitamin K1; vitamin K2.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Chain structures of vitamin K1 (phylloquinone [PK]), two vitamin K2 isoforms (menaquinone 4 [MK‐4] and menaquinone 7 [MK‐7]), and vitamin K3 (menadione). Created in BioRender. Dupuy, M. (2024) BioRender.com/m97w819.
FIGURE 2
FIGURE 2
Phylloquinone content in common dietary sources based on data from four countries: Australia (Palmer, Koch, et al. 2021), the USA (U.S. Department of Agriculture n.d.), the United Kingdom (McCance and Widdowson 2014), and Denmark (National Food Institute, Technical University of Denmark 2024).
FIGURE 3
FIGURE 3
Menaquinone‐4 content in common dietary sources based on data from five published databases, from four different regions: Australia (Palmer, Koch, et al. 2021), the USA (U.S. Department of Agriculture n.d.), the Netherlands (Schurgers and Vermeer 2000), and Denmark (National Food Institute, Technical University of Denmark ; Jensen et al. 2025). Values were left blank where no data was available.
FIGURE 4
FIGURE 4
The vitamin K cycle. Created in BioRender. Dupuy, M. (2024) BioRender.com/p68j777.
See this image and copyright information in PMC

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