Tags

Type your tag names separated by a space and hit enter

Homocysteine levels and the risk of osteoporotic fracture.
N Engl J Med 2004; 350(20):2033-41NEJM

Abstract

BACKGROUND

Very high plasma homocysteine levels are characteristic of homocystinuria, a rare autosomal recessive disease accompanied by the early onset of generalized osteoporosis. We therefore hypothesized that mildly elevated homocysteine levels might be related to age-related osteoporotic fractures.

METHODS

We studied the association between circulating homocysteine levels and the risk of incident osteoporotic fracture in 2406 subjects, 55 years of age or older, who participated in two separate prospective, population-based studies. In the Rotterdam Study, there were two independent cohorts: 562 subjects in cohort 1, with a mean follow-up period of 8.1 years; and 553 subjects in cohort 2, with a mean follow-up period of 5.7 years. In the Longitudinal Aging Study Amsterdam, there was a single cohort of 1291 subjects, with a mean follow-up period of 2.7 years. Multivariate Cox proportional-hazards regression models were used for analysis of the risk of fracture, with adjustment for age, sex, body-mass index, and other characteristics that may be associated with the risk of fracture or with increased homocysteine levels.

RESULTS

During 11,253 person-years of follow-up, osteoporotic fractures occurred in 191 subjects. The overall multivariable-adjusted relative risk of fracture was 1.4 (95 percent confidence interval, 1.2 to 1.6) for each increase of 1 SD in the natural-log-transformed homocysteine level. The risk was similar in all three cohorts studied, and it was also similar in men and women. A homocysteine level in the highest age-specific quartile was associated with an increase by a factor of 1.9 in the risk of fracture (95 percent confidence interval, 1.4 to 2.6). The associations between homocysteine levels and the risk of fracture appeared to be independent of bone mineral density and other potential risk factors for fracture.

CONCLUSIONS

An increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women.

Authors+Show Affiliations

Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. j.vanmeurs@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15141041

Citation

van Meurs, Joyce B J., et al. "Homocysteine Levels and the Risk of Osteoporotic Fracture." The New England Journal of Medicine, vol. 350, no. 20, 2004, pp. 2033-41.
van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med. 2004;350(20):2033-41.
van Meurs, J. B., Dhonukshe-Rutten, R. A., Pluijm, S. M., van der Klift, M., de Jonge, R., Lindemans, J., ... Uitterlinden, A. G. (2004). Homocysteine levels and the risk of osteoporotic fracture. The New England Journal of Medicine, 350(20), pp. 2033-41.
van Meurs JB, et al. Homocysteine Levels and the Risk of Osteoporotic Fracture. N Engl J Med. 2004 May 13;350(20):2033-41. PubMed PMID: 15141041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine levels and the risk of osteoporotic fracture. AU - van Meurs,Joyce B J, AU - Dhonukshe-Rutten,Rosalie A M, AU - Pluijm,Saskia M F, AU - van der Klift,Marjolein, AU - de Jonge,Robert, AU - Lindemans,Jan, AU - de Groot,Lisette C P G M, AU - Hofman,Albert, AU - Witteman,Jacqueline C M, AU - van Leeuwen,Johannes P T M, AU - Breteler,Monique M B, AU - Lips,Paul, AU - Pols,Huibert A P, AU - Uitterlinden,André G, PY - 2004/5/14/pubmed PY - 2004/5/18/medline PY - 2004/5/14/entrez SP - 2033 EP - 41 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 350 IS - 20 N2 - BACKGROUND: Very high plasma homocysteine levels are characteristic of homocystinuria, a rare autosomal recessive disease accompanied by the early onset of generalized osteoporosis. We therefore hypothesized that mildly elevated homocysteine levels might be related to age-related osteoporotic fractures. METHODS: We studied the association between circulating homocysteine levels and the risk of incident osteoporotic fracture in 2406 subjects, 55 years of age or older, who participated in two separate prospective, population-based studies. In the Rotterdam Study, there were two independent cohorts: 562 subjects in cohort 1, with a mean follow-up period of 8.1 years; and 553 subjects in cohort 2, with a mean follow-up period of 5.7 years. In the Longitudinal Aging Study Amsterdam, there was a single cohort of 1291 subjects, with a mean follow-up period of 2.7 years. Multivariate Cox proportional-hazards regression models were used for analysis of the risk of fracture, with adjustment for age, sex, body-mass index, and other characteristics that may be associated with the risk of fracture or with increased homocysteine levels. RESULTS: During 11,253 person-years of follow-up, osteoporotic fractures occurred in 191 subjects. The overall multivariable-adjusted relative risk of fracture was 1.4 (95 percent confidence interval, 1.2 to 1.6) for each increase of 1 SD in the natural-log-transformed homocysteine level. The risk was similar in all three cohorts studied, and it was also similar in men and women. A homocysteine level in the highest age-specific quartile was associated with an increase by a factor of 1.9 in the risk of fracture (95 percent confidence interval, 1.4 to 2.6). The associations between homocysteine levels and the risk of fracture appeared to be independent of bone mineral density and other potential risk factors for fracture. CONCLUSIONS: An increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/15141041/Homocysteine_levels_and_the_risk_of_osteoporotic_fracture_ L2 - http://www.nejm.org/doi/full/10.1056/NEJMoa032546?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -