Homocysteine and bone mineral density in older females in the United States (257.5)

Abstract

Previous studies suggest that elevated total homocysteine (tHcy, >13 µmol/L) is a risk factor for bone fracture and osteoporosis; but the data are equivocal and no mechanism has been demonstrated. Elevated tHcy can be caused by impaired renal function, genetic factors, or suboptimal B‐vitamin status. We examined the relationship between tHcy and total body and lumbar spine bone mineral density (BMD) in females 蠅50 years participating in NHANES 1999‐2004(n=2,923). These years had concurrent measurement of tHcy, MMA, RBC folate, serum B‐12, and whole‐body dual‐energy X‐ray absorptiometry. Elevated tHcy was significantly associated with lower total and lumbar BMD when compared to normal tHcy (p <0.001) before and after controlling for age, race/ethnicity, kidney function, BMI, physical activity, intakes of calcium and vitamin D and use of estrogen/progesterone. For example, females with elevated tHcy were more likely to have lumbar spine osteoporosis when compared to females with normal tHcy [OR 2.22 (95%CI:1.3,3.9), p <0.001]. Serum MMA, vitamin B‐12 and RBC folate were not significantly related to BMD. In this population of older females, tHcy appears to be an independent risk factor for low total body and lumbar spine BMD. The role of genetic and other factors that may elevate tHcy concentrations and adversely affect BMD should be explored.Grant Funding Source: Supported by the Office of Dietary Supplements