Plasma homocysteine level is a risk factor for osteoporotic fractures in elderly patients

Abstract

ObjectiveTo study the relationship of plasma homocysteine (Hcy), bone turnover biomarkers (BTB), and bone mineral density (BMD) with osteoporotic fracture (OPF) in elderly people.MethodsEighty-two patients (aged 65 years or older) admitted to our orthopedics department between October 2014 and May 2015 were randomly divided into three groups: 1) OPF group: 39 cases with the mean age 81.82±5.49 years, which included 24 females and 15 males; 2) high-energy fracture (HEF) group: 22 cases with the mean age 78.88±5.75 years, which included 16 females and six males; 3) non-bone-fracture group: 21 cases with mean age 79.75±5.47 years without bone fracture, which included 14 females and seven males. Plasma Hcy, BTB, and BMD were measured. Analysis of variance and multiple regression analysis were used in the statistical analysis.ResultsThere was no significant difference in either age or sex among the three groups. There were significant differences in plasma Hcy and hip BMD between the OPF and HEF groups; there was also significant difference in plasma Hcy, 25-(OH) Vit D, and hip BMD between the OPF and non-fracture groups. There was no difference in lumbar spine BMD between the OPF group and the other two groups. There was no significant difference in plasma Hcy, 25-(OH) Vit D, hip or lumbar spine BMD between the HEF and non-fracture group. There was no significant difference in procollagen type I N-propeptide of type I collagen, serum C-terminal cross-linking telopeptide of type I collagen, and parathyroid hormone among the three groups. Plasma Hcy was linearly correlated with age and serum C-terminal cross-linking telopeptide of type I collagen, but not correlated with either hip or lumbar spine BMD or any other BTBs.ConclusionIn this study, we found that the plasma Hcy level in elderly patients with OPF is higher than that of nonosteoporotic patients. It is not correlated with BMD, but positively correlated with bone resorption markers. An increased Hcy level appears to be a risk factor for OPFs in elderly people.

Hyperhomocysteinemia is Associated with Inflammation, Bone Resorption, Vitamin B12 and Folate Deficiency and MTHFR C677T Polymorphism in Postmenopausal Women with Decreased Bone Mineral Density

“…Hcy is now emerging as another important risk factor for osteoporosis development, since it plays an important role in bone metabolism, both directly and through the synergy of inflammatory processes and nutritional deficits. In accordance with recent studies [39,40], we hypothesize a combined role of inflammation and Hcy in the pathogenesis of osteoporosis in postmenopausal women. The serum level of Hcy is increased in postmenopausal women and an association of hyperhomocysteinemia with increased fracture risk has been suggested [41].…”

Evaluation of bone mineral density and its correlation with homocysteine and other biochemical bone markers in postmenopausal women

“…The present study is in accordance with the study by Bahtiri et al, Bozkurt et al have found that plasma Hcy levels were increased in osteoporosis in a cross-sectional analysis of Turkish postmenopausal women, Zhu et al, also found high Hcy was associated with increased hip bone loss in elderly women. 10,11,16 Our study also showed significant negative correlation of Hcy with BMD as in studies by Bahtiri et al, Bucciarelli et al and Baines et al which showed similar findings. 10,17,18 Studies by Van Meurs et al, didn't find any association of Hcy and BMD and results from a study on Italian postmenopausal women observed no direct relation between levels of Hcy and BMD.…”

Serum Homocysteine and Reactive Species Levels in Fragility Fractures of the Pelvis

“…Plasma Hcy levels are significantly higher in the group F compared with the group C(p<0.001). Similarly, researchers in another study [23] found that Hcy level in elderly patients with osteoporotic fracture is higher than that of non-osteoporotic patients. Numerous studies show that although high levels of homocysteine are a risk factor for fractures, they are not correlated with bone mineral density.…”