Homocysteine, Vitamin B12, and Folate: Do They Affect Osteoporotic Vertebral Fracture Risk?

X-ray images of spinal fractureResearchers looked at the impact of homocysteine, vitamin B12, and folate on the prevalence of asymptomatic osteoporotic vertebral fractures (VFs) in postmenopausal women.

Their findings appeared online in February 2012 in the article “Homocysteine, folate, and vitamin B12 levels and vertebral fracture risk in postmenopausal women.” The article will appear in an upcoming edition of the Journal of Clinical Densitometry.

A total of 188 women participated in the study. The mean age of the women was 57.9±8.5 (41 to 91) years old, and the average weight was 74.4±13.5 (38 to 150) kg. Average body mass index of the women was 30.4±5.2 (17.1 to 50.7) kg/m2.

Researchers used vertebral fracture assessment (VFA) to evaluate these women. Specifically, they used a LUNAR Prodigy bone densitometer (manufactured by GE Healthcare) to obtain lateral VFA images and scans of the lumbar spine and proximal femur in these women.

They discovered that 58 of the women (30.9%) had densitometric osteoporosis.

The researchers also used a Genant’s semi-quantitative approach and morphometry to help them define vertebral fractures.

Using VFA, vertebral fractures were identified in 76 of the women (40.4%). They found that 61 women had grade 1 VFs and 15 women had grade 2 or 3 VFs.

Researchers broke out the women into 3 groups: absence of VFs, grade 1 VFs, and grades 2 or 3 VFs. In regard to the biological parameters, no statistical difference was shown between the 3 groups.

When researchers compared the women according to quartiles of homocysteine levels, their data showed that the women in the highest quartile were both older and had a lower bone mineral density (BMD). But in regard to prevalence of VFs, they found that there was no statistical difference from that of the participants in the other quartile groups.

Additionally, the researchers used stepwise regression analysis in the study, which showed that homocysteine was not independently linked to vertebral fractures. The VFs were mostly related to the osteoporosis status of the women.

The research team observed a weak link between hyperhomocysteinemia and low BMD and a trend of higher prevalence of grades 2 or 3 VFs in study participants. However, the study did not prove that homocysteine, vitamin B12, and folate levels are important factors when it comes to the prevalence of asymptomatic osteoporotic vertebral fractures in postmenopausal women.

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