Association between Serum Vitamin B12 Level and Bone Mineral Density in Older Women
Vitamin B12 Level and Bone Mineral Density(BMD)
,
Abstract
Background: Vitamin B12 is a micronutrient essential for deoxyribonucleic acid (DNA) synthesis, which can affect osteogenesis. Based on in-vivo investigations, vitamin B12 is associated with osteogenesis, and low levels of this vital vitamin in the human body can be related to an increased risk of osteoporosis.
Methods: In this descriptive-analytical study, 60 women over 65 years who visited an orthopedic clinic were included. They were divided into three groups based on bone density in the hip and lumbar areas using dual-energy X-ray absorptiometry (DEXA) scans, including normal bone density, osteopenia, and osteoporosis. The average serum level of vitamin B12 in the experimental subjects was then determined and compared.
Results: 6 (10%) showed normal bone density, 25 (41.7%) osteopenia, and 29 (48.3%) were considered to have osteoporosis. Measured vitamin B12 levels showed no statistically significant difference between the two groups of normal bone density (601.3 ± 194.8) and osteopenia (560.4 ± 131.5). However, there was a significant statistical difference between vitamin B12 levels in people with osteoporosis (400.7 ± 162.4) and the two groups of normal and osteopenic individuals. There was also a negative statistical relationship between vitamin B12 levels and bone density (P = 0.004, r = -0.8).
Conclusion: A low serum level of vitamin B12 is associated with a severe decline in bone density in elderly Iranian women.
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2. Saltzman JR, Russell RM. The aging gut. Nutritional issues.
Gastroenterol Clin North Am. 1998;27(2):309-24. doi: 10.1016/s0889-8553(05)70005-4. [PubMed: 9650019].
3. Selhub J, Bagley LC, Miller J, Rosenberg IH. B vitamins, homocysteine, and neurocognitive function in the elderly. Am J Clin Nutr. 2000;71(2):614S-20S. doi: 10.1093/ajcn/71.2.614s. [PubMed: 10681269].
4. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999;19:357-77. doi: 10.1146/annurev.nutr.19.1.357. [PubMed: 10448529].
5. Wolters M, Strohle A, Hahn A. Cobalamin: A critical vitamin in the elderly. Prev Med. 2004;39(6):1256-66. doi: 10.1016/j.ypmed.2004.04.047. [PubMed: 15539065].
6. Brattstrom L, Wilcken DE. Homocysteine and cardiovascular disease: cause or effect? Am J Clin Nutr. 2000;72(2):315-23. doi: 10.1093/ajcn/72.2.315. [PubMed: 10919920].
7. Mangoni AA, Jackson SH. Homocysteine and cardiovascular disease: Current evidence and future prospects. Am J Med. 2002;112(7):556-65. doi: 10.1016/s0002-9343(02)01021-5. [PubMed: 12015248].
8. Nygard O, Vollset SE, Refsum H, Brattstrom L, Ueland PM. Total homocysteine and cardiovascular disease. J Intern Med. 1999;246(5):425-54. doi: 10.1046/j.1365-2796.1999.00512.x. [PubMed: 10583714].
9. Rosenberg IH. B vitamins, homocysteine, and neurocognitive function. Nutr Rev. 2001;59(8 Pt 2):S69-S73. doi: 10.1111/j.1753- 4887.2001.tb05503.x. [PubMed: 11519670].
10. Carmel R. Current concepts in cobalamin deficiency. Annu Rev Med. 2000;51:357-75. doi: 10.1146/annurev.med.51.1.357. [PubMed: 10774470].
11. Holroyd C, Cooper C, Dennison E. Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab. 2008;22(5):671-85. doi: 10.1016/j.beem.2008.06.001. [PubMed: 19028351].
12. Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med. 1998;49:31-62. doi: 10.1146/annurev.med.49.1.31. [PubMed: 9509248].
13. Golbahar J, Hamidi A, Aminzadeh MA, Omrani GR. 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. 2004;35(3):760-5. doi: 10.1016/j.bone.2004.04.018. [PubMed: 15336613].
14. Morris MS, Jacques PF, Selhub J. Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. Bone. 2005;37(2):234-42. doi: 10.1016/j.bone.2005.04.017. [PubMed: 15950558].
15. Stone KL, Bauer DC, Sellmeyer D, Cummings SR. Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: A prospective study. J Clin Endocrinol Metab. 2004;89(3):1217-21. doi: 10.1210/jc.2003-030074. [PubMed: 15001613].
16. Dhonukshe-Rutten RA, Lips M, de Jong N, Chin APM, Hiddink GJ, van Dusseldorp M, et al. Vitamin B-12 status is associated with bone mineral content and bone mineral density in frail elderly women but not in men. J Nutr. 2003;133(3):801-7. doi: 10.1093/jn/133.3.801. [PubMed: 12612156].
17. Cagnacci A, Baldassari F, Rivolta G, Arangino S, Volpe A. Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone. 2003;33(6):956-9. doi: 10.1016/j.bone.2003.07.001. [PubMed: 14678855].
18. Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. Effect of folate and mecobalamin on hip fractures in patients with stroke: A randomized controlled trial. JAMA. 2005;293(9):1082-8. doi: 10.1001/jama.293.9.1082. [PubMed: 15741530].
19. McLean RR, Jacques PF, Selhub J, Fredman L, Tucker KL, Samelson EJ, et al. Plasma B vitamins, homocysteine, and their relation with bone loss and hip fracture in elderly men and women. J Clin Endocrinol Metab. 2008;93(6):2206-12. doi: 10.1210/jc.2007- 2710. [PubMed: 18364381]. [PubMed Central: PMC2435634].
20. Fleurence RL. Cost-effectiveness of fracture prevention treatments in the elderly. Int J Technol Assess Health Care. 2004;20(2):184-91. doi: 10.1017/s0266462304000960. [PubMed: 15209178].
21. Vakili M, Forooghan M, Nojomi M, Ghaleh Bandi MF, Khodabandeloo N. A survey on serum levels of B12, folate and homocysteine in healthy elderly Tehranis. Razi J Med Sci. 2009;16(63):189-200. [In Persian].
22. Hong X, Hsu YH, Terwedow H, Tang G, Liu X, Jiang S, et al.
Association of the methylenetetrahydrofolate reductase C677T polymorphism and fracture risk in Chinese postmenopausal women. Bone. 2007;40(3):737-42. doi: 10.1016/j.bone.2006.09.031.
[PubMed: 17174622]. [PubMed Central: PMC1855293].
23. Yilmaz N, Kepkep N, Cicek HK, Celik A, Meram I. Relation of parity and homocysteine to bone mineral density of postmenopausal women. Clin Lab. 2006;52(1-2):49-56. [PubMed: 16506364].
24. Zhang H, Tao X, Wu J. Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: A meta-analysis. Arch Gynecol Obstet. 2014;289(5):1003- 9. doi: 10.1007/s00404-013-3075-6. [PubMed: 24193243].
25. Haliloglu B, Aksungar FB, Ilter E, Peker H, Akin FT, Mutlu N, et al. Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women. Arch Gynecol Obstet. 2010;281(4): 663-8. doi: 10.1007/s00404-009-1297-4. [PubMed: 19946695].
26. Bozkurt N, Erdem M, Yilmaz E, Erdem A, Biri A, Kubatova A, et al. The relationship of homocyteine, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet. 2009;280(3):381-7. doi: 10.1007/s00404-009-0936-0. [PubMed: 19151987].
27. You L, Sheng Z, Zhang L, Chen J. Relation of serum vitamin B12 and serum folate to bone mineral density in postmenopansal women. Chinese Journal of Osteoporosis. 2007;13(1):26-8.
28. Selhub J. The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr. 2006;136(6 Suppl):1726S- 30S. doi: 10.1093/jn/136.6.1726S. [PubMed: 16702347].
29. Herrmann M, Kraenzlin M, Pape G, Sand-Hill M, Herrmann W. Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post- menopausal women. Clin Chem Lab Med. 2005;43(10):1118-23. doi: 10.1515/CCLM.2005.195. [PubMed: 16197308].
2. Saltzman JR, Russell RM. The aging gut. Nutritional issues.
Gastroenterol Clin North Am. 1998;27(2):309-24. doi: 10.1016/s0889-8553(05)70005-4. [PubMed: 9650019].
3. Selhub J, Bagley LC, Miller J, Rosenberg IH. B vitamins, homocysteine, and neurocognitive function in the elderly. Am J Clin Nutr. 2000;71(2):614S-20S. doi: 10.1093/ajcn/71.2.614s. [PubMed: 10681269].
4. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999;19:357-77. doi: 10.1146/annurev.nutr.19.1.357. [PubMed: 10448529].
5. Wolters M, Strohle A, Hahn A. Cobalamin: A critical vitamin in the elderly. Prev Med. 2004;39(6):1256-66. doi: 10.1016/j.ypmed.2004.04.047. [PubMed: 15539065].
6. Brattstrom L, Wilcken DE. Homocysteine and cardiovascular disease: cause or effect? Am J Clin Nutr. 2000;72(2):315-23. doi: 10.1093/ajcn/72.2.315. [PubMed: 10919920].
7. Mangoni AA, Jackson SH. Homocysteine and cardiovascular disease: Current evidence and future prospects. Am J Med. 2002;112(7):556-65. doi: 10.1016/s0002-9343(02)01021-5. [PubMed: 12015248].
8. Nygard O, Vollset SE, Refsum H, Brattstrom L, Ueland PM. Total homocysteine and cardiovascular disease. J Intern Med. 1999;246(5):425-54. doi: 10.1046/j.1365-2796.1999.00512.x. [PubMed: 10583714].
9. Rosenberg IH. B vitamins, homocysteine, and neurocognitive function. Nutr Rev. 2001;59(8 Pt 2):S69-S73. doi: 10.1111/j.1753- 4887.2001.tb05503.x. [PubMed: 11519670].
10. Carmel R. Current concepts in cobalamin deficiency. Annu Rev Med. 2000;51:357-75. doi: 10.1146/annurev.med.51.1.357. [PubMed: 10774470].
11. Holroyd C, Cooper C, Dennison E. Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab. 2008;22(5):671-85. doi: 10.1016/j.beem.2008.06.001. [PubMed: 19028351].
12. Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med. 1998;49:31-62. doi: 10.1146/annurev.med.49.1.31. [PubMed: 9509248].
13. Golbahar J, Hamidi A, Aminzadeh MA, Omrani GR. 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. 2004;35(3):760-5. doi: 10.1016/j.bone.2004.04.018. [PubMed: 15336613].
14. Morris MS, Jacques PF, Selhub J. Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. Bone. 2005;37(2):234-42. doi: 10.1016/j.bone.2005.04.017. [PubMed: 15950558].
15. Stone KL, Bauer DC, Sellmeyer D, Cummings SR. Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: A prospective study. J Clin Endocrinol Metab. 2004;89(3):1217-21. doi: 10.1210/jc.2003-030074. [PubMed: 15001613].
16. Dhonukshe-Rutten RA, Lips M, de Jong N, Chin APM, Hiddink GJ, van Dusseldorp M, et al. Vitamin B-12 status is associated with bone mineral content and bone mineral density in frail elderly women but not in men. J Nutr. 2003;133(3):801-7. doi: 10.1093/jn/133.3.801. [PubMed: 12612156].
17. Cagnacci A, Baldassari F, Rivolta G, Arangino S, Volpe A. Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone. 2003;33(6):956-9. doi: 10.1016/j.bone.2003.07.001. [PubMed: 14678855].
18. Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. Effect of folate and mecobalamin on hip fractures in patients with stroke: A randomized controlled trial. JAMA. 2005;293(9):1082-8. doi: 10.1001/jama.293.9.1082. [PubMed: 15741530].
19. McLean RR, Jacques PF, Selhub J, Fredman L, Tucker KL, Samelson EJ, et al. Plasma B vitamins, homocysteine, and their relation with bone loss and hip fracture in elderly men and women. J Clin Endocrinol Metab. 2008;93(6):2206-12. doi: 10.1210/jc.2007- 2710. [PubMed: 18364381]. [PubMed Central: PMC2435634].
20. Fleurence RL. Cost-effectiveness of fracture prevention treatments in the elderly. Int J Technol Assess Health Care. 2004;20(2):184-91. doi: 10.1017/s0266462304000960. [PubMed: 15209178].
21. Vakili M, Forooghan M, Nojomi M, Ghaleh Bandi MF, Khodabandeloo N. A survey on serum levels of B12, folate and homocysteine in healthy elderly Tehranis. Razi J Med Sci. 2009;16(63):189-200. [In Persian].
22. Hong X, Hsu YH, Terwedow H, Tang G, Liu X, Jiang S, et al.
Association of the methylenetetrahydrofolate reductase C677T polymorphism and fracture risk in Chinese postmenopausal women. Bone. 2007;40(3):737-42. doi: 10.1016/j.bone.2006.09.031.
[PubMed: 17174622]. [PubMed Central: PMC1855293].
23. Yilmaz N, Kepkep N, Cicek HK, Celik A, Meram I. Relation of parity and homocysteine to bone mineral density of postmenopausal women. Clin Lab. 2006;52(1-2):49-56. [PubMed: 16506364].
24. Zhang H, Tao X, Wu J. Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: A meta-analysis. Arch Gynecol Obstet. 2014;289(5):1003- 9. doi: 10.1007/s00404-013-3075-6. [PubMed: 24193243].
25. Haliloglu B, Aksungar FB, Ilter E, Peker H, Akin FT, Mutlu N, et al. Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women. Arch Gynecol Obstet. 2010;281(4): 663-8. doi: 10.1007/s00404-009-1297-4. [PubMed: 19946695].
26. Bozkurt N, Erdem M, Yilmaz E, Erdem A, Biri A, Kubatova A, et al. The relationship of homocyteine, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet. 2009;280(3):381-7. doi: 10.1007/s00404-009-0936-0. [PubMed: 19151987].
27. You L, Sheng Z, Zhang L, Chen J. Relation of serum vitamin B12 and serum folate to bone mineral density in postmenopansal women. Chinese Journal of Osteoporosis. 2007;13(1):26-8.
28. Selhub J. The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr. 2006;136(6 Suppl):1726S- 30S. doi: 10.1093/jn/136.6.1726S. [PubMed: 16702347].
29. Herrmann M, Kraenzlin M, Pape G, Sand-Hill M, Herrmann W. Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post- menopausal women. Clin Chem Lab Med. 2005;43(10):1118-23. doi: 10.1515/CCLM.2005.195. [PubMed: 16197308].
| Files | ||
| Issue | Vol 8, No 3 (2022) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v8i3.9905 | |
| Keywords | ||
| : Bone Density Bone Diseases Osteoporosis Vitamin B12 | ||
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How to Cite
1.
Navaeifar N, Tabriz A, Motalebizadeh M. Association between Serum Vitamin B12 Level and Bone Mineral Density in Older Women. J Orthop Spine Trauma. 2022;8(3):83-6.
