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Archives of Gynecology and Obstetrics

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01-05-2014 | General Gynecology

Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis

Authors: Hongxiu Zhang, Xincheng Tao, Jie Wu

Published in: Archives of Gynecology and Obstetrics | Issue 5/2014

Abstract

Background

The relationship of homocysteine (Hcy), folate, and vitamin B12 with bone mineral density (BMD) has been investigated in postmenopausal women. However, the relationship is still controversial.

Purpose

To evaluate the association of Hcy, folate, vitamin B12 and BMD in postmenopausal women with a meta-analysis.

Methods

We searched for all published articles indexed in Medline (1950–2012), Embase (1974–2012), and China National Knowledge Infrastructure (1994–2012). Any case–control or cohort study relating to Hcy, vitamin B12, folate, and BMD was included, and the data were extracted independently by two reviewers. Criteria for inclusion were the assessment of Hcy, vitamin B12, folate, and BMD in postmenopausal women as outcomes. We performed this meta-analysis with Review Manager 5.1 software. Odds ratios and 95 % confidence intervals (CI) were used to evaluate the results.

Results

Six eligible studies were selected for meta-analysis. Our analysis suggested that vitamin B12 and Hcy levels were significantly higher in postmenopausal osteoporosis (PMOP) group than that in controls (P = 0.007, <0.05; 95 % CI 3.06–19.38 and P = 0.0003, <0.05; 95 % CI 0.75–2.52, respectively). Folate level was lower in PMOP group than that in controls, but this difference was not statistically significant (P = 0.09, 95 % CI −3.33 to 0.25).

Conclusions

Hcy and vitamin B12, but not folate, were related to BMD in PMOP. Extra vitamin B12 may not play a protective role for osteoporosis in postmenopausal women. Future studies are needed to confirm them, especially the relationship between increased vitamin B12 and BMD.

Yilmaz N, Kepkep N, Cicek HK, Celik A, Meram I (2006) Relation of parity and homocysteine to bone mineral density of postmenopausal women. Clin Lab 52:49–56PubMed

Hong X, Hsu YH, Terwedow H, Tang G, Liu X et al (2007) Association of the methylenetetrahydrofolate reductase C677T polymorphism and fracture risk in Chinese postmenopausal women. Bone 40:737–742PubMedCentralPubMedCrossRef

Ettinger BHS, Kendler D, Kessel B, McClung M (2006) Management of osteoporosis in postmenopausal women: 2006 position statement of The North American Menopause Society. Menopause 13:340–367 quiz 368-349CrossRef

Sirmali M, Turut H, Topcu S, Gulhan E, Yazici U et al (2003) A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 24:133–138PubMedCrossRef

IH N (2001) NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, March 7-29, 2000: highlights of the conference. South Med J 94:569–573

Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J et al (1993) Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341:72–75PubMedCrossRef

Kanis JA, Black D, Cooper C, Dargent P, Dawson-Hughes B et al (2002) A new approach to the development of assessment guidelines for osteoporosis. Osteoporos Int 13:527–536PubMedCrossRef

van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R et al (2004) Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 350:2033–2041PubMedCrossRef

McLean RR, Jacques PF, Selhub J, Tucker KL, Samelson EJ et al (2004) Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med 350:2042–2049PubMedCrossRef

10.

Baines M, Kredan MB, Usher J, Davison A, Higgins G et al (2007) The association of homocysteine and its determinants MTHFR genotype, folate, vitamin B12 and vitamin B6 with bone mineral density in postmenopausal British women. Bone 40:730–736PubMedCrossRef

11.

Bucciarelli P, Martini G, Martinelli I, Ceccarelli E, Gennari L et al (2010) The relationship between plasma homocysteine levels and bone mineral density in post-menopausal women. Eur J Intern Med 21:301–305PubMedCrossRef

12.

El Maghraoui A, Ghozlani I, Mounach A, Rezqi A, Oumghar K et al (2012) Homocysteine, folate, and vitamin B12 levels and vertebral fracture risk in postmenopausal women. J Clin Densitom 15:328–333PubMedCrossRef

13.

Gjesdal CG, Vollset SE, Ueland PM, Refsum H, Drevon CA et al (2006) Plasma total homocysteine level and bone mineral density: the Hordaland Homocysteine Study. Arch Intern Med 166:88–94PubMedCrossRef

14.

Bozkurt N, Erdem M, Yilmaz E, Erdem A, Biri A et al (2009) The relationship of homocysteine, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet 280:381–387PubMedCrossRef

15.

Cagnacci A, Baldassari F, Rivolta G, Arangino S, Volpe A (2003) Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone 33:956–959PubMedCrossRef

16.

Selhub J (2006) The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr 136:1726S–1730SPubMed

17.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012PubMedCrossRef

18.

Tucker KL, Hannan MT, Qiao N, Jacques PF, Selhub J et al (2005) Low plasma vitamin B12 is associated with lower BMD: the Framingham Osteoporosis Study. J Bone Miner Res 20:152–158PubMedCrossRef

19.

Holstein JH, Herrmann M, Splett C, Herrmann W, Garcia P et al (2009) Low serum folate and vitamin B-6 are associated with an altered cancellous bone structure in humans. Am J Clin Nutr 90:1440–1445PubMedCrossRef

20.

Martinez-Ramirez MJ, Palma Perez S, Delgado-Martinez AD, Martinez-Gonzalez MA, De la Fuente Arrillaga C et al (2007) Vitamin C, vitamin B12, folate and the risk of osteoporotic fractures. A case-control study. Int J Vitam Nutr Res 77:359–368PubMedCrossRef

21.

Morris MS, Jacques PF, Selhub J (2005) Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. Bone 37:234–242PubMedCrossRef

22.

McLean RR, Jacques PF, Selhub J, Fredman L, Tucker KL et al (2008) Plasma B vitamins, homocysteine, and their relation with bone loss and hip fracture in elderly men and women. J Clin Endocrinol Metab 93:2206–2212PubMedCentralPubMedCrossRef

23.

Yazdanpanah N, Zillikens MC, Rivadeneira F, de Jong R, Lindemans J et al (2007) Effect of dietary B vitamins on BMD and risk of fracture in elderly men and women: the Rotterdam study. Bone 41:987–994PubMedCrossRef

24.

Dhonukshe-Rutten RA, Pluijm SM, de Groot LC, Lips P, Smit JH et al (2005) Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people. J Bone Miner Res 20:921–929PubMedCrossRef

25.

Gjesdal CG, Vollset SE, Ueland PM, Refsum H, Meyer HE et al (2007) Plasma homocysteine, folate, and vitamin B 12 and the risk of hip fracture: the hordaland homocysteine study. J Bone Miner Res 22:747–756PubMedCrossRef

26.

Golbahar J, Aminzadeh MA, Hamidi SA, Omrani GR (2005) Association of red blood cell 5-methyltetrahydrofolate folate with bone mineral density in postmenopausal Iranian women. Osteoporos Int 16:1894–1898PubMedCrossRef

27.

Golbahar J, Hamidi A, Aminzadeh MA, Omrani GR (2004) Association of plasma folate, plasma total homocysteine, but not methylenetetrahydrofolate reductase C667T polymorphism, with bone mineral density in postmenopausal Iranian women: a cross-sectional study. Bone 35:760–765PubMedCrossRef

28.

Haliloglu B, Aksungar FB, Ilter E, Peker H, Akin FT et al (2010) Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women. Arch Gynecol Obstet 281:663–668PubMedCrossRef

29.

Ouzzif Z, Oumghar K, Sbai K, Mounach A, Derouiche el M et al (2012) Relation of plasma total homocysteine, folate and vitamin B12 levels to bone mineral density in Moroccan healthy postmenopausal women. Rheumatol Int 32:123–128PubMedCrossRef

30.

You L, Sheng Z, Zhang L, Chen J (2007) Relation of serum vitamin B12 and serum folate to bone mineral density in postmenopausal women. Chin J Osteoporos 13:26–28

31.

Rumbak I, Zizic V, Sokolic L, Cvijetic S, Kajfez R et al (2012) Bone mineral density is not associated with homocysteine level, folate and vitamin B12 status. Arch Gynecol Obstet 285:991–1000PubMedCrossRef

32.

Krivosikova Z, Krajcovicova-Kudlackova M, Spustova V, Stefikova K, Valachovicova M et al (2010) The association between high plasma homocysteine levels and lower bone mineral density in Slovak women: the impact of vegetarian diet. Eur J Nutr 49:147–153PubMedCrossRef

33.

Herrmann M, Widmann T, Herrmann W (2005) Homocysteine—a newly recognised risk factor for osteoporosis. Clin Chem Lab Med 43:1111–1117PubMed

34.

Herrmann M, Kraenzlin M, Pape G, Sand-Hill M, Herrmann W (2005) Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post-menopausal women. Clin Chem Lab Med 43:1118–1123PubMed

Title: Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis
Authors: Hongxiu Zhang
Xincheng Tao
Jie Wu
Publication date: 01-05-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-3075-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis

Abstract

Background

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusions

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