LEMMO Integrated Cancer Care Inc.

Jun

2004

Homocysteine levels may be related to osteoporosisBy Laurie Barclay, MD. Dr. Lemmo Health Briefs, June 2004.

May 12, 2004 - Homocysteine levels are associated with osteoporotic hip fracture, according to the results of two studies published in the May 13 issue of the New England Journal of Medicine.

"Although a previous study suggested the possible involvement of increased plasma homocysteine levels in age-dependent bone loss, the role of moderately elevated plasma homocysteine levels in diseases of the skeletal system - in particular, osteoporotic fracture - is unknown."

The investigators studied the association between circulating homocysteine levels and the risk of incident osteoporotic fracture in 2,406 subjects, aged 55 years or older, enrolled in two separate prospective, population-based studies. Patients in the highest age-specific quartile for homocysteine level had a 90% increase in fracture risk.

"An increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women," the authors write, while recommending that this risk be confirmed in other large population studies.

The second study looked at the association between total homocysteine concentration and the risk of hip fracture in men and women enrolled in the Framingham Study. Between 1979 and 1982, blood samples to measure plasma total homocysteine were obtained from 825 men and 1,174 women, ranging in age from 59 to 91 years.

Compared with men and women in the lowest quartile for total homocysteine, those in the highest quartile had nearly quadruple the risk of hip fracture for men and nearly double for women,

"These findings suggest that the homocysteine concentration, which is easily modifiable by means of dietary intervention, is an important risk factor for hip fracture in older persons," the authors write. "Further population-based research is needed to examine the role of homocysteine in osteoporosis and osteoporotic fracture and to determine whether nationwide folic acid fortification of food will help to reduce rates of hip fracture in the United States."

Dr. Lemmo's Comments

For those that are not yet familiar with "Homocysteine", in general, it is a chemical made in the body that tends to rise when the body is low in certain B-vitamins (i.e. folic acid, B12, B6). Some medications may also contribute to high levels as well. High homocysteine levels are more commonly tested for patients with heart disease problems and are virtually unknown in the "osteoporosis world". During the past year, low levels of vitamin B12 was also associated with higher osteoporosis risks which may be related to homocysteine metabolism. While we do not know if taking B-vitamins will reduce a persons risk of bone fracture, homocysteine testing and the experimental use of these vitamins may be a very prudent consideration (especially when considering the high safety of these nutrients and the potential dangers of fractures).

References

N Engl J Med. 2004;350:2033-2041, 2042-2049, 2089-2090