The Effects of Warfarin on Bone Metabolism

Objectives: Osteocalcin which is s non-collagenous protein plays an important role in bone metabolism and its carboxylation depends on vitamin K. In addition, warfarin inhibits vitamin K epoxide reductase complex and has an anticoagulant effect and therefore interrupts the activity of osteocalcin. Accordingly, this study aimed to estimate the effects of warfarin on bone metabolism. In other words, it was attempted to evaluate the changes in serum levels of bone metabolism in warfarin-taking patients and find the relationship between the inhibition of vitamin K metabolism by warfarin and their synergistic effects on bone metabolism. Materials and Methods: A total of 72 individuals were selected including healthy controls (n = 36) and patients (n = 36) who referred to clinical laboratories of Tabriz after consuming warfarin. Nearly 5 ml blood samples were collected and non-carboxylated osteocalcin experiments, parathyroid hormone (PTH), vitamin D3, calcium, phosphorus, magnesium, and alkaline phosphatase were performed for all the samples of each group. Results: In this study, non-carboxylated osteocalcin, PTH, and international normalized ratio (INR) increased significantly in the case group while increasing of Mg2+ was non-significant in this group. However, vitamin D3, Ca2+, alkaline phosphatase (ALP), and P demonstrated a significant decrease in the case group compared to the control group. Conclusions: In general, the consumption of warfarin leads to bone and vessel wall damages, causing cardiovascular diseases.