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Serum homocysteine, folate and vitamin B12 in patients with Paget’s disease of bone: the effect of zoledronic acid

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Abstract

High serum homocysteine (HCY) and indirectly deficiency of folate and/or vitamin B12 stimulate bone resorption and adversely affect collagen cross-linking. The aim of this study was the evaluation of serum levels of HCY, folate and vitamin B12 in patients with Paget’s disease of bone (PDB) and the effect of zoledronic acid (ZOL) on their serum levels. Nine consecutive patients with polyostotic PDB (median age 66 years) received a single 5-mg ZOL infusion. Blood samples for HCY, folate, vitamin B12, 25-hydroxyvitamin D (25-OH-D), total serum alkaline phosphatase (TSAP), bone-specific serum alkaline phosphatase (BSAP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were obtained at baseline and 3, 6 and 12 months after ZOL infusion. Twelve age-, gender- and BMI-matched healthy individuals were recruited for the control group at baseline assessment. Patients with PDB had significantly higher serum HCY (p = 0.028), folate (p < 0.001) and bone markers [TSAP (p < 0.001), BSAP (p < 0.001) and CTX (p < 0.001)] compared with the control group at baseline. In the pagetic group, serum HCY significantly decreased 3 months after ZOL infusion and remained essentially unchanged up to the end of the study (p = 0.005). Serum vitamin B12 and folate remained unaffected throughout the study. Our data suggest that serum HCY levels are increased in patients with PDB. A single ZOL infusion results in a decrease in HCY levels that might represent another mechanism for the reduction of the activity of PDB achieved by ZOL.

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Authors and Affiliations

  1. Department of Endocrinology, Ippokration General Hospital, 13 Simou Lianidi, 551 34, Thessaloniki, Greece

    Stergios A. Polyzos, Zoe Efstathiadou, Ioannis Litsas, Marina Kita & Athanasios Panagiotou

  2. Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece

    Athanasios D. Anastasilakis

  3. Department of Medical Research, 251 General Airforce Hospital, Athens, Greece

    Athanasios Papatheodorou & Evangelos Terpos

  4. Department of Nuclear Medicine, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece

    Georgios Arsos & Efstratios Moralidis

  5. Department of Radiology, Ippokration General Hospital, Thessaloniki, Greece

    Georgios Barmpalios & Efthimia Zafeiriadou

  6. Laboratory of Biochemistry, Ippokration General Hospital, Thessaloniki, Greece

    Efthimia Triantafillidou & Eleni Makrigiannaki

Authors
  1. Stergios A. Polyzos
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  2. Athanasios D. Anastasilakis
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  3. Zoe Efstathiadou
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  8. Georgios Arsos
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  9. Efstratios Moralidis
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  14. Evangelos Terpos
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Correspondence to Stergios A. Polyzos.

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Polyzos, S.A., Anastasilakis, A.D., Efstathiadou, Z. et al. Serum homocysteine, folate and vitamin B12 in patients with Paget’s disease of bone: the effect of zoledronic acid. J Bone Miner Metab 28, 314–319 (2010). https://doi.org/10.1007/s00774-009-0131-1

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  • DOI: https://doi.org/10.1007/s00774-009-0131-1

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