The relationship between plasma homocysteine levels and bone mineral density in post-menopausal women

Bucciarelli, Paolo; Martini, Giuseppe; Martinelli, Ida; Ceccarelli, Elena; Gennari, Luigi; Bader, Rossella; Valenti, Roberto; Franci, Beatrice; Nuti, Ranuccio; Mannucci, Pier Mannuccio

doi:10.1016/j.ejim.2010.03.017

« Previous Next »European Journal of Internal Medicine
Volume 21, Issue 4 , Pages 301-305, August 2010

The relationship between plasma homocysteine levels and bone mineral density in post-menopausal women

Paolo Bucciarelli
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Corresponding author. Hemophilia and Thrombosis Center, Fondazione IRCCS Cà Granda — Ospedale Maggiore Policlinico, Via Pace, 9-20122 Milan, Italy. Tel.: +39 02 55035274; fax: +39 02 50320723.
Giuseppe Martini
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Ida Martinelli
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
Elena Ceccarelli
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Luigi Gennari
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Rossella Bader
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
Roberto Valenti
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Beatrice Franci
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Ranuccio Nuti
- Department of Internal Medicine, Endocrinology, Metabolism and Biochemistry, Section of Internal Medicine, University of Siena, Siena, Italy
Pier Mannuccio Mannucci
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

Received 28 January 2010; received in revised form 12 March 2010; accepted 30 March 2010. published online 30 April 2010.

Abstract

Background

Whether or not mild hyperhomocysteinemia and low serum levels of folates or vitamin B12 are risk factors for osteoporosis in the elderly is controversial.

Aims and methods

To investigate whether or not plasma levels of total homocysteine (tHcy) and serum levels of folates and vitamin B12 are associated with bone mineral density (BMD), we carried out a cross-sectional study on 446 post-menopausal women (mean age: 65.1±9.4years), consecutively seen at the Siena Unit (Tuscany region, Central Italy) for BMD evaluation over a two-year period. BMD of the total femur, femoral neck and lumbar spine was detected by dual-energy X-ray absorptiometry.

Results

The age-adjusted geometric mean of plasma tHcy levels (µmol/L) was 9.96±1.29 in women with normal BMD, 11.06±1.32 in those with osteopenia and 11.88±1.35 in those with osteoporosis (p<0.0001). On multiple linear regression analysis, adjusting for age, body mass index, folates, vitamin B12, creatinine clearance, smoking habit and alcohol intake, tHcy was negatively related to BMD of the total femur [β estimate for log-homocysteine: −0.050 (95% CI: −0.100 to −0.001, p=0.048; R²=0.02)], but not of femoral neck or lumbar spine. There was no significant association between BMD and serum levels of folates and vitamin B12.

Conclusions

tHcy is negatively associated with BMD of the total femur. The contribution of tHcy to explain the variance of BMD is small (2% of the total variance) but clinically relevant, considering the high prevalence of osteoporosis among post-menopausal women and the possibility to lower tHcy by vitamin supplementation.

Keywords: Homocysteine, Osteoporosis, Menopause