Menaquinone pathways of action associated with bone metabolism. Menaquinone is cofactor for GGCX, which catalyses activation of OC. Vitamin K2 also inhibits NF-κB activation induced by cytokines (RANKL, TNFα), which leads to inhibition of osteoclastogenesis and activation of osteoblastogenesis. Another mechanism includes activation of nuclear receptor PXR in osteoblasts, which increases expression of genes encoding bone matrix proteins. Abbreviations: RANKL, receptor activator of nuclear factor kappa-Β ligand; TNFα, tumour necrosis factor alpha; NF-κB, nuclear factor-kappa B; AP, alkaline phosphatase; PXR, pregnane X receptor; OC, osteocalcin; Gla-OC, carboxylated osteocalcin.