B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States
B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States
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DOI：
10.3945/ajcn.115.108787
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发表时间：
2015-09-01
影响因子：
7.1
通讯作者：
Mills, James L.
中科院分区：
文献类型：
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作者：
Bailey, Regan L.;Looker, Anne C.;Mills, James L.
背景：既往数据表明血清总同型半胱氨酸（tHcy）升高可能是骨折和骨质疏松症的危险因素。 tHcy 升高的营养原因是 B 族维生素状态不佳。据我们所知，这是第一份关于叶酸强化人群 B 族维生素与骨骼健康关系的全国代表性报告。目的：本分析的目的是检查 B 族维生素状态生物标志物与骨矿物质密度 (BMD)、骨质疏松症风险和骨转换生物标志物之间的关系。设计：我们检查了 tHcy、甲基丙二酸 (MMA) 和血清/红细胞叶酸与全身和腰椎的关系参与全国代表性横断面调查 NHANES 1999-2004 (n = 2806) 的 50 岁以上女性 BMD。这是唯一同时进行 tHcy 测量和全身双能 X 射线吸收测定法的年份。我们还检查了 1999-2002 年子集中的 B 族维生素生物标志物与骨转换标志物、骨碱性磷酸酶和尿 I 型胶原蛋白 N 端交联端肽 (n = 1813) 的关系。结果：与最佳浓度相比，tHcy 升高的女性年龄较大，血清维生素 B-12、红细胞叶酸和膳食微量营养素摄入量较低，并且骨转换的平均值 +/- SE 标志物显着较高（骨碱性磷酸酶：15.8 +/- 0.59 与 14.0 +/- 0.25 μg/L 相比；尿 I 型胶原蛋白 N 端交联端肽：48.2 +/- 2.9 与每 mmol 肌酐/L 38.9 +/- 0.90 nmol 骨胶原当量相比）。 MMA（OR：1.88；95% CI：1.10，3.18）和tHcy（OR：2.17；95% CI：1.14，4.15）升高与腰椎骨质疏松症风险增加相关。当作为连续变量进行检查时，tHcy 呈负相关，血清叶酸呈正相关，MMA 和维生素 B-12 与腰椎和全身 BMD 没有显着相关。结论：在通过食品强化和膳食补充剂大量接触 B 族维生素的美国老年女性的全国代表性人群中，只有升高的 tHcy 和 MMA 与腰椎骨质疏松症风险独立相关。
Background: Previous data suggest that elevated serum total homocysteine (tHcy) may be a risk factor for bone fracture and osteoporosis. Nutritional causes of elevated tHcy are suboptimal B-vitamin status. To our knowledge, this is the first nationally representative report on the relation of B vitamins and bone health from a population with folic acid fortification.Objective: The purpose of this analysis was to examine the relation between B-vitamin status biomarkers and bone mineral density (BMD), risk of osteoporosis, and biomarkers of bone turnover.Design: We examined the relation of tHcy, methylmalonic acid (MMA), and serum/red blood cell folate and total-body and lumbar spine BMD in women aged >= 50 y participating in the NHANES 1999-2004 (n = 2806), a nationally representative cross-sectional survey. These are the only years with concurrent measurement of tHcy and whole-body dual-energy X-ray absorptiometry. We also examined B-vitamin biomarkers relative to bone turnover markers, bone alkaline phosphatase, and urinary N-terminal cross-linked telopeptide of type I collagen in a 1999-2002 subset with available data (n = 1813).Results: In comparison with optimal concentrations, women with elevated tHcy were older with lower serum vitamin B-12, red blood cell folate, and dietary micronutrient intakes and had significantly higher mean +/- SE markers of bone turnover (bone alkaline phosphatase: 15.8 +/- 0.59 compared with 14.0 +/- 0.25 mu g/L; urinary N-terminal crosslinked telopeptide of type I collagen: 48.2 +/- 2.9 compared with 38.9 +/- 0.90 nmol bone collagen equivalents per mmol creatinine/L). Elevated MMA (OR: 1.88; 95% CI: 1.10, 3.18) and tHcy (OR: 2.17; 95% CI: 1.14, 4.15) were related to increased risk of lumbar osteoporosis. When examined as a continuous variable, tHcy was negatively associated, serum folates were positively associated, and MMA and vitamin B-12 were not significantly associated with lumbar and total-body BMD.Conclusion: In this nationally representative population of older US women with high exposure to B vitamins through food fortification and dietary supplements, only elevated tHcy and MMA were independently associated with risk of lumbar spine osteoporosis.