High homocysteine bad for the bones

Women who have high levels of the amino acid homocysteine in the blood are at increased risk for low bone mineral density (BMD), European investigators report. “Our finding adds to the increasing evidence that homocysteine is important for bone health,” lead author Dr. Clara Gram Gjesdal from the University of Bergen in Norway told Reuters Health.

“Osteoporosis is a major public health problem with increasing consequences as people live longer,” she said. “If the modest associations observed in our study are causal, the public health implications may be significant because high homocysteine levels respond to intake of folate and other B vitamins.”

Using data from a population-based cohort of more than 5,300 middle-aged and elderly men and women, researchers observed that total homocysteine level was inversely related to hip BMD among middle-aged and elderly women, but not among men.

Women with high homocysteine levels were nearly two times more likely to have low BMD compared with women with low homocysteine levels.

Moreover, high homocysteine predicted osteoporosis among women after adjusting for confounding factors such as smoking, physical activity, intake of vitamin D and calcium, and use of estrogen, Gjesdal said.

Two “trendsetting articles” published last year, Gjesdal mentioned, showed that total homocysteine is a risk factor for osteoporotic bone fractures in men and women. Subjects in the highest quartile of homocysteine had an approximately two-fold higher risk of suffering a fracture compared to those in the three lower quartiles.

High homocysteine may be a “potential modifiable risk factor for osteoporosis in women,” the authors conclude. “Randomized trials are needed to investigate whether B vitamin supplementation affects BMD and fracture risk,” Gjesdal added.

SOURCE: Archives of Internal Medicine, January 9, 2006.

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