Elevated Homocysteine Levels Linked to Osteoporosis 30075

Elevated Homocysteine Levels Linked to Osteoporosis

ROTTERDAM, The Netherlands--A study published in the May 13 issue of TheNew England Journal of Medicine (350, 20:2033-2041, 2004) (http://content.nejm.org/cgi/content/short/350/20/2033)found increased homocysteine levels may be a considerable, independent riskfactor for osteoporotic fractures in older men and women. High homocysteinelevels in blood plasma are characteristic of homocystinuria, a rare autosomalrecessive disease linked to early onset of generalized osteoporosis.

The authors of the study examined the relationship between circulatinghomocysteine levels and the incidence of osteoporotic fractures in 2,406subjects 55 years of age or older who participated in two different prospective,population-based studies. One of the two studies consisted of two independentgroups: 562 subjects in the first group, with a mean follow-up period of 8.1years; and 553 subjects in the second group, with a mean follow-up period of 5.7years. The other study consisted of a single group of 1,291 subjects, with amean follow-up period of 2.7 years. Risk of fracture was assessed afteradjustment for age, sex, body-mass index, and other characteristics that may beassociated with the risk of fracture or with increased homocysteine levels.

Throughout the follow-up period, 191 subjects sustained osteoporoticfractures. The overall multivariable-adjusted relative risk of fracture was 1.4for each increase of one standard deviation in the natural-log-transformedhomocysteine level. The researchers found the risk similar in all three groupsstudied, as well as in men and women. The relationship between homocysteinelevels and the risk of fracture appeared to be independent of other potentialrisk factors for fracture, such as bone mineral density.

The researchers concluded an elevated homocysteine level appears to be asignificant, isolated risk factor for osteoporotic fractures in elderly men andwomen.

It has been suggested folic acid supplementation can be used to lowerhomocysteine levels in the April 9, 1998 issue of The New England Journal ofMedicine (338, 15: 1009-1015, 1998) and in the Dec. 18, 1996 issue of the Journalof the American Medical Association (276, 23:1879-1885, 1996).