Abstract
ABSTRACTThe role of micronutrients such as folate and vitamin B‐12 in bone quality has been widely studied with conflicting results. Ethnicity seems to play a large role on nutrient intake, as diet varies across cultures. In this study, we examined the relationships of BMD, proximal femur strength, and bone resorption with plasma folate and vitamin B‐12 in a cohort of 93 healthy postmenopausal women of Chinese‐Singaporean descent. The parameters examined were areal (aBMD) and volumetric BMD (vBMD) of the proximal femur and the third lumbar vertebra (L3), total body aBMD, proximal femur bending, compressive and impact strength indices (composite strength indices) and circulating levels of C‐telopeptide of type I collagen. Eighteen participants (19.4%) had aBMD in the osteoporotic range (osteoporosis group), 59 (63.4%) in the osteopenic range (osteopenia group), and the remaining 16 (17.2%) in the normal range (normal BMD group). Circulating folate levels were significantly higher in the normal BMD group compared with the osteoporosis group. Using linear regression analysis, we found that overall, aBMD and vBMD are positively associated with folate concentrations, whereas composite strength indices were positively associated with vitamin B‐12 concentrations. These findings support the existing literature and suggest a link between levels of circulating folate/vitamin B‐12 and BMD/bone strength in the cohort examined. Further investigation is needed to examine if individuals with inadequate circulating levels of these nutrients could decrease their risk for fragility fractures through better nutrition or vitamin supplementation. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Highlights
Osteoporosis is a bone disease that affects primarily postmenopausal women
To the best of our knowledge, this is the first study to investigate the relationship of plasma folate and vitamin B-12 concentrations with areal BMD (aBMD) and volumetric BMD (vBMD), proximal femur strength, and bone resorption in healthy postmenopausal Chinese-Singaporean women
We concluded that circulating folate is positively associated with proximal femur aBMD and vBMD, total-body aBMD, and L3 vBMD; circulating vitamin B-12 levels correlated positively with bending and compression strength indices of the proximal femur
Summary
Osteoporosis is a bone disease that affects primarily postmenopausal women. It is caused by an imbalance between the formation and resorption of bone and is characterized by low BMD, deterioration of bone microstructure, and increased risk of fragility fractures.Folate (vitamin B-9) and cobalamin (vitamin B-12) are two vitamins of the B-complex that affect bone health both directly and indirectly, as deficiencies in these micronutrients have been linked to elevated homocysteine levels.[1]. Osteoporosis is a bone disease that affects primarily postmenopausal women. It is caused by an imbalance between the formation and resorption of bone and is characterized by low BMD, deterioration of bone microstructure, and increased risk of fragility fractures. Folate (vitamin B-9) and cobalamin (vitamin B-12) are two vitamins of the B-complex that affect bone health both directly and indirectly, as deficiencies in these micronutrients have been linked to elevated homocysteine levels.[1] High levels of circulating homocysteine have been shown in in vitro studies to cause collagen cross-linking impairment,(2,3) as well as to impact osteoclast[4] and osteoblast[5] activity, leading to poor bone health and 1 of 9 n fragility fractures.[6,7] Supplementation with B-complex vitamins, including folate and vitamin B-12, lowered homocysteine levels in a group of older people, but interestingly did not improve bone turnover, as seen from levels of serum bone biomarkers of bone resorption (degradation products of type I collagen) and formation (bone-specific alkaline phosphatase).(8) there is no clear consensus on the relationships of circulating folate and vitamin B-12 levels with bone health. There is limited knowledge of any relationships between these two micronutrients and bone volume, microarchitecture, or BMD of the individual bone compartments (cortical, trabecular)
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