Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden
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In a population-based study on cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C.
Cobalamin deficiency in elderlies may affect bone metabolism. This study aims to determine whether serum cobalamins or holotranscobalamin (holoTC; the metabolic active cobalamin) predict incident fractures in old men.
Men participating in the Gothenburg part of the population-based Osteoporotic Fractures in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the present study (n = 790; age range, 70–81 years).
During an average follow-up of 5.9 years, 110 men sustained X-ray-verified fractures including 45 men with clinical vertebral fractures. The risk of fracture (adjusted for age, smoking, BMI, BMD, falls, prevalent fracture, tHcy, cystatin C, 25-OH-vitamin D, intake of calcium, and physical activity (fully adjusted)), increased per each standard deviation decrease in cobalamins (hazard ratio (HR), 1.38; 95 % confidence intervals (CI), 1.11–1.72) and holoTC (HR, 1.26; 95 % CI, 1.03–1.54), respectively. Men in the lowest quartile of cobalamins and holoTC (fully adjusted) had an increased risk of all fracture (cobalamins, HR = 1.67 (95 % CI, 1.06–2.62); holoTC, HR = 1.74 (95 % CI, 1.12–2.69)) compared with quartiles 2–4. No associations between folate or tHcy and incident fractures were seen.
We present novel data showing that low levels of holoTC and cobalamins predicting incident fracture in elderly men. This association remained after adjustment for BMI, BMD, tHcy, and cystatin C. However, any causal relationship between low cobalamin status and fractures should be explored in a prospective treatment study.
KeywordsCobalamins Holotranscobalamin Homocysteine Fractures Men
The research was supported by the Swedish Research Council, the Swedish Foundation for Strategic Research, and the ALF/LUA research grant in Gothenburg.
Conflicts of interest
- 2.Lewerin C, Jacobsson S, Lindstedt G, Nilsson-Ehle H (2008) Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly: implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. Scand J Gastroenterol 43:1050–1056PubMedCrossRefGoogle Scholar
- 20.Ribom EL, Grundberg E, Mallmin H, Ohlsson C, Lorenzon M, Orwoll E, Holmberg AH, Mellstrom D, Ljunggren O, Karlsson MK (2009) Estimation of physical performance and measurements of habitual physical activity may capture men with high risk to fall—data from the Mr Os Sweden cohort. Arch Gerontol Geriatr 49:e72–e76PubMedCrossRefGoogle Scholar
- 24.Johansson H, Oden A, Lerner UH, et al. (2012) High serum adiponectin predicts incident fractures in elderly men. Mr OS Sweden. J Bone Miner Res 27:1390–1396Google Scholar
- 26.Harrell FE (ed) (2001) General aspects of fitting regression models: regression modeling strategies. Springer, New YorkGoogle Scholar
- 28.Lewerin C, Nilsson-Ehle H, Jacobsson S, Karlsson MK, Ohlsson C, Mellstrom D (2013) Holotranscobalamin is not influenced by decreased renal function in elderly men: the MrOS Sweden study. Ann Clin Biochem (in press)Google Scholar
- 34.Herrmann M, Umanskaya N, Wildemann B, Colaianni G, Schmidt J, Widmann T, Zallone A, Herrmann W (2007) Accumulation of homocysteine by decreasing concentrations of folate, vitamin B12 and B6 does not influence the activity of human osteoblasts in vitro. Clin Chim Acta 384:129–134PubMedCrossRefGoogle Scholar
- 38.Lewerin C, Matousek M, Steen G, Johansson B, Steen B, Nilsson-Ehle H (2005) Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study. Am J Clin Nutr 81:1155–1162PubMedGoogle Scholar
- 40.Ensrud KE, Parimi N, Cauley JA, Ishani A, Slinin Y, Hillier TA, Taylor BC, Steffes M, Cummings SR (2013) Cystatin C and risk of hip fractures in older women. J Bone Miner Res (in press)Google Scholar