Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people
Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people
复制标题
DOI：
10.1359/jbmr.050202
复制
发表时间：
2005-06-01
影响因子：
6.2
通讯作者：
van Staveren, W
中科院分区：
文献类型：
--
作者：
Dhonukshe-Rutten, RAM;Pluijm, SMF;van Staveren, W
高同型半胱氨酸血症可能导致骨质疏松症的发生。阿姆斯特丹纵向衰老研究的 1267 名受试者研究了 Hey 和维生素 B-12 与骨转换标志物、BUA 和骨折发生率的关系。高Hey和低维生素B-12浓度与低BUA、高骨转换标志物和骨折风险增加显着相关。简介：高同型半胱氨酸血症可能导致骨质疏松症的发生。维生素 B-12 与同型半胱氨酸 (Hey) 密切相关。我们研究的主要目的是检查 Hey 和维生素 B-12 状态之间的关联，以及这两者与宽带超声衰减 (BUA)、骨转换标志物和骨折的综合效应。 材料和方法：阿姆斯特丹纵向衰老研究 (LASA) 的受试者为 615 名男性和 652 名女性，平均年龄为 76 +/- 6.6 (SD) 岁。在基线（1995/1996），在禁食乳制品过夜后采集血样。使用 IMx 测量血浆 Hey，使用竞争性免疫分析 (IA) 发光测量血清维生素 B-12，使用免疫放射分析 (IRMA) 测量血清骨钙素 (OC)，使用竞争性 IA 测量尿脱氧吡啶啉 (DPD) 排泄，并校正肌酐 (Cr) 浓度。 CV 分别为 4%、5%、8% 和 5%。对左右跟骨的跟骨 BUA 进行了两次评估。根据这四次测量计算平均 BUA 值。 CV为3.4%。 1.995年基线测量后，对骨折进行了为期3年的前瞻性随访，直至1998/1999年。根据维生素 13,2 浓度、正常与低 (< 200 pM) 或最低四分位数 (Q1) 与正常四分位数 (Q2-Q4) 以及 Hey 浓度、正常与高 (> 15 muM) 或最高四分位数 (Q4) 与正常四分位数 (Q1-Q3)，使用两种不同的方法对受试者进行分组。根据 Hey 和维生素 B-12 的指定类别，进行协方差分析，计算 BUA、OC 和 DPD/Cr-尿液的平均值，并调整几个混杂因素（潜在的混杂因素包括年龄、性别、体重、身高、当前吸烟[是/否]、活动能力、认知）。通过 Cox 回归分析评估任何骨折的相对风险 (RR)。当分别研究 Hey 和维生素 13,2 与骨折发生率的关系时，使用了四分位数。结果：14% 的男性和 9% 的女性具有较高的 Hey (> 15 muM) 浓度和较低的维生素 B-12 (< 200 pM) 浓度。维生素 B-12 水平 < 200 pM 且 Hey 浓度 > 15 μM 的女性比同龄人具有更低的 BUA、更高的 DPD/Cr 和更高的 OC 浓度。在男性中，不同的 Hey 和维生素 B-12 类别之间在 BUA、OC 或 DPD/Cr-尿液的调整后平均值上没有发现差异。在 3 年的随访期间，28 名男性和 43 名女性发生骨折。与 Hey 和维生素 B-12 浓度正常的男性相比，Hey 和/或维生素 B-12 浓度低的男性骨折调整后 RR (95% CI) 为 3.8 (1.2-11.6)。高 Hey 和/或低维生素 B-12 浓度的女性骨折调整后 RR 为 2.8 (1.3-5.7)。结论：高 Hey 和低维生素 B-12 浓度与低 BUA、高骨转换标志物和骨折风险增加显着相关。
Hyperhomocysteinemia may contribute to the development of osteoporosis. The relationship of Hey and vitamin B-12 with bone turnover markers, BUA, and fracture incidence was studied in 1267 subjects of the Longitudinal Aging Study Amsterdam. High Hey and low vitamin B-12 concentrations were significantly associated with low BUA, high markers of bone turnover, and increased fracture risk.Introduction: Hyperhomocysteinemia may contribute to the development of osteoporosis. Vitamin B-12 is closely correlated to homocysteine (Hey). The main objective of our study was to examine the association of Hey and vitamin B-12 status and the combined effect of these two with broadband ultrasound attenuation (BUA), bone turnover markers, and fracture.Materials and Methods: Subjects were 615 men and 652 women with a mean age of 76 +/- 6.6 (SD) years of the Longitudinal Aging Study Amsterdam (LASA). At baseline (1995/1996), blood samples were taken after an overnight fast for dairy products. Plasma Hey was measured with IMx, serum vitamin B-12 with competitive immunoassay (IA) luminescence, serum osteocalcin (OC) with immunoradiometric assay (IRMA), and urinary excretion of deoxypyridinoline (DPD) with competitive IA and corrected for creatinine (Cr) concentration. CVs were 4%, 5%, 8%, and 5%, respectively. BUA was assessed in the heel bone twice in both the right and left calcaneus. Mean BUA value was calculated from these four measurements. CV was 3.4%. After baseline measurements in 1.995, a 3-year prospective follow-up of fractures was carried out until 1998/1999. Subjects were grouped by using two different approaches on the basis of their vitamin 13,2 concentration, normal versus low (< 200 pM) or lowest quartile (Q1) versus normal quartiles (Q2-Q4), and Hey concentration, normal versus high (> 15 mu M) or highest quartile (Q4) versus normal quartiles (Q1-Q3). Analysis of covariance was performed to calculate mean values of BUA, OC, and DPD/Cr-urine, based on the specified categories of Hey and vitamin B-12 and adjusted for several confounders (potential confounders were age, sex, body weight, body height, current smoking [yes/no], mobility, cognition). The relative risk (RR) of any fracture was assessed with Cox regression analysis. Quartiles were used when Hey and vitamin 13,2 were separately studied in their relationship with fracture incidence. Results: Fourteen percent of the men and 9% of the women had high Hey (> 15 mu M) and low vitamin B-12 (< 200 pM) concentrations. Women with vitamin B-12 levels < 200 pM and Hey concentrations >15 mu M had lower BUA, higher DPD/Cr, and higher OC concentrations than their counterparts. In men, no differences were found between the different Hey and vitamin B-12 categories in adjusted means of BUA, OC, or DPD/ Cr-urine. Twenty-eight men and 43 women sustained a fracture during the 3-year follow-up period. The adjusted RR for fractures (95% CI) for men with high Hey and/or low vitamin B-12 concentrations was 3.8 (1.2-11.6) compared with men with normal Hey and vitamin B-12 concentrations. Women with high Hey and/or low vitamin B-12 concentrations had an adjusted RR for fractures of 2.8 (1.3-5.7).Conclusions: High Hey and low vitamin B-12 concentrations were significantly associated with low BUA, high markers of bone turnover, and increased fracture risk.