Plasma homocysteine, folate, and vitamin B12 and the risk of hip fracture:: The hordaland homocysteine study
Plasma homocysteine, folate, and vitamin B12 and the risk of hip fracture:: The hordaland homocysteine study
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DOI：
10.1359/jbmr.070210
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发表时间：
2007-05-01
影响因子：
6.2
通讯作者：
Tell, Grethe S.
中科院分区：
文献类型：
--
作者：
Gjesdal, Clara Gram;Vollset, Stein Emil;Tell, Grethe S.
在4766名老年男性和女性中评估同型半胱氨酸和相关因素作为随后髋部骨折的危险因素。高水平的同型半胱氨酸和低水平的叶酸预测骨折，而维生素B-12和基因型与骨折风险无关。高同型半胱氨酸可能是髋部fraction.Introduction的一个可改变的危险因素：血浆总同型半胱氨酸（tHcy）升高，叶酸和维生素B-12缺乏与骨质疏松症和骨折的风险。我们检查了血浆tHCy、叶酸和维生素B-12水平以及亚甲基四氢叶酸还原酶（MTHFR）677 C-> T）T和1298 C-> T多态性是否可以预测髋部骨折。材料和方法：这是一项基于人群的前瞻性研究，研究对象为1992-1993年入组时年龄为65-67岁的2639名女性和2127名男性。髋部骨折的信息来自于该地区从入组至2005年11月30日期间所有住院患者的出院诊断的计算机记录。考克斯比例风险回归估计骨折的风险，根据血浆同型半胱氨酸，叶酸，维生素13的水平，并为不同的genotype.Results：在一个中位数为12.6年的随访期间，髋部骨折记录在1.84（7.0%）的妇女和90（4.2%）的男子。高tHcy水平（>= 15 μ M）与低tHcy水平（< 9.0 μ M）受试者骨折的校正风险比（95%CI）在女性中为2.42（1.43-4.09），在男性中为1.37（0.63-2.98）。剂量反应分析表明，男性和女性的血浆tHcy与骨折风险呈正相关，而女性的血浆叶酸与骨折风险呈负相关。调整混杂因素后，血浆维生素B12水平或MTHFR基因型与骨折风险无显著相关性。通过调整血浆维生素B-12和叶酸水平，tHcy和髋部骨折风险之间的关联仅略有减弱。结论：tHcy似乎是老年男性和女性髋部骨折的预测因子。叶酸仅在女性中是预测因子，而维生素B-12和MTHFR基因型不能预测髋部骨折。我们的数据证实了同型半胱氨酸可能在骨质疏松性骨折的发病机制中发挥作用的假设。
Homocysteine and related factors were evaluated as risk factors for subsequent hip fractures among 4766 elderly men and women. High levels of homocysteine and low levels of folate predicted fracture, whereas vitamin B-12 and genotypes were not related to fracture risk. High homocysteine may be a modifiable risk factor for hip fracture.Introduction: Elevated plasma total homocysteine (tHcy) and deficiencies of folate and vitamin B-12 are associated with risk of osteoporosis and fracture. We examined whether plasma levels of tHcy, folate, and vitamin B-12 and the methylenetetrahydrofolate reductase (MTHFR) 677C -> T)T and 1298C -> T polymorphisms predicted hip fracture.Materials and Methods: This was a population-based prospective study of 2639 women and 2127 men who were 65-67 yr at enrollment in 1992-1993. Information on hip fracture was obtained from computerized records of discharge diagnoses from all hospitalizations in the region in the period between enrollment and November 30, 2005. Cox proportional hazard regression was used to estimate fracture risk according to levels of plasma tHcy, folate, and vitamin 13, and for different genotypes.Results: Over a median follow-up period of 12.6 yr, hip fracture was recorded in 1.84 (7.0%) women and 90 (4.2%) men. The adjusted hazard ratio (95% CI) for fracture in subjects with high (>= 15 mu M) compared with low levels (< 9.0 mu M) of tHcy was 2.42 (1.43-4.09) among women and 1.37 (0.63-2.98) among men. Dose response analyses indicated a positive association between plasma tHcy and risk of fracture in both sexes and a negative association between plasma folate and risk of fracture among women only. Plasma vitamin B12 level or MTHFR genotype was not significantly related to risk of fracture after adjustments for confounding factors. The association between tHcy and risk of hip fracture was only slightly weakened by adjustments for plasma levels of vitamin B-12 and folate.Conclusions: tHcy seems to be a predictor for hip fracture among elderly men and women. Folate was a predictor among women only, whereas vitamin B-12 and MTHFR genotype did not predict hip fracture. Our data corroborate the hypothesis that homocysteine may play a role in the pathogenesis of osteoporotic fractures.