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The journal of nutrition, health & aging

, Volume 17, Issue 6, pp 578–584 | Cite as

Elevated homocysteine levels are associated with low muscle strength and functional limitations in older persons

  • K. M. A. Swart
  • N. M. Van Schoor
  • M. W. Heymans
  • L. A. Schaap
  • M. Den Heijer
  • P. Lips
Article

Abstract

Objective

The current study aimed to examine homocysteine in relation to different aspects of physical functioning.

Design, setting and participants

Cross-sectional and longitudinal data (3-years follow-up) from the Longitudinal Aging Study Amsterdam (LASA) were used. The study was performed in persons aged ≥ 65 years (N= 1301 after imputation).

Measurements

Different measures of physical functioning, including muscle mass, grip strength, functional limitations, and falling were regarded as outcomes. Gender and serum creatinine level were investigated as effect modifiers.

Results

Results were stratified by gender. In men, higher homocysteine levels were associated with lower grip strength (Quartile 4: regression coefficient (B)= −3.07 (−4.91; −1.22)), and more functional limitations at baseline (Quartile 4: B= 1.15 (0.16–2.14)). In women, higher homocysteine levels were associated with more functional limitations after 3 years (Quartile 4: B= 1.19 (0.25; 2.13)). Higher homocysteine levels were not associated with low muscle mass or falling.

Conclusions

These data suggest an inverse association of homocysteine levels with functional limitations in older men and women, and with muscle strength in older men.

Key words

Homocysteine physical functioning muscle aging 

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References

  1. 1.
    de Bree A, van der Put NMJ, Mennen LI, Verschuren WMM, Blom HJ, Galan P, Bates CJ, Herrmann W, Ullrich M, Dierkes J, Westphal S, Bouter LM, et al (2005) Prevalences of hyperhomocysteinemia, unfavorable cholesterol profile and hypertension in European populations. Eur J Clin Nutr 59:480–488.CrossRefPubMedGoogle Scholar
  2. 2.
    Refsum H, Nurk E, Smith AD, Ueland PM, Gjesdal CG, Bjelland I, Tverdal A, Tell GS, Nygard O, Vollset SE (2006) The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 136(6 Suppl):1731S–1740S.PubMedGoogle Scholar
  3. 3.
    Antoniades C, Antonopoulos AS, Tousoulis D, Marinou K, Stefanadis C (2009) Homocysteine and coronary atherosclerosis: from folate fortification to the recent clinical trials. Eur Heart J 30:6–15.CrossRefPubMedGoogle Scholar
  4. 4.
    Durga J, van Boxtel MPJ, Schouten EG, Kok FJ, Jolles J, Katan MB, Verhoef P (2007) Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet 369:208–216.CrossRefPubMedGoogle Scholar
  5. 5.
    Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D’Agostino RB, Wilson PWF, Wolf PA (2002) Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. N Engl J Med 346:476–483.CrossRefPubMedGoogle Scholar
  6. 6.
    Leboff MS, Narweker R, LaCroix A, Wu L, Jackson R, Lee J, Bauer DC, Cauley J, Kooperberg C, Lewis C, Thomas AM, Cummings S (2009) Homocysteine levels and risk of hip fracture in postmenopausal women. J Clin Endocrinol Metab 94:1207–1213.CrossRefPubMedGoogle Scholar
  7. 7.
    McLean RR, Jacques PF, Selhub J, Fredman L, Tucker KL, Samelson EJ, Kiel DP, Cupples LA, Hannan MT (2008) Plasma B vitamins, homocysteine, and their relation with bone loss and hip fracture in elderly men and women. J Clin Endocrinol Metab 93:2206–2212.CrossRefPubMedGoogle Scholar
  8. 8.
    van Meurs JBJ, Dhonukshe-Rutten RAM, Pluijm SMF, van der Klift M, de Jonge R, Lindemans J, de Groot LCPG, Hofman A, Witteman JCM, van Leeuwen JPTM, Breteler MMB, Lips P, et al (2004) Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 350:2033–2041.CrossRefPubMedGoogle Scholar
  9. 9.
    Gerdhem P, Ivaska KK, Isaksson A, Pettersson K, Vaananen HK, Obrant KJ, Akesson K (2007) Associations between homocysteine, bone turnover, BMD, mortality, and fracture risk in elderly women. J Bone Miner Res 22:127–134.CrossRefPubMedGoogle Scholar
  10. 10.
    Gjesdal CG, Vollset SE, Ueland PM, Refsum H, Drevon CA, Gjessing HK, Tell GS (2006) Plasma total homocysteine level and bone mineral density: the Hordaland Homocysteine Study. Arch Intern Med 166:88–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Morris MS, Jacques PF, Selhub J. Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. Bone 2005 Aug;37(2):234–242.CrossRefPubMedGoogle Scholar
  12. 12.
    Saito M, Fujii K, Marumo K (2006) Degree of mineralization-related collagen crosslinking in the femoral neck cancellous bone in cases of hip fracture and controls. Calcif Tissue Int 79:160–168.CrossRefPubMedGoogle Scholar
  13. 13.
    Vaes BLT, Lute C, Blom HJ, Bravenboer N, de Vries TJ, Everts V, Dhonukshe-Rutten RA, Muller M, de Groot LCPG, Steegenga WT (2009). Vitamin B(12) deficiency stimulates osteoclastogenesis via increased homocysteine and methylmalonic acid. Calcif Tissue Int 84:413–422.CrossRefPubMedGoogle Scholar
  14. 14.
    Kado DM, Bucur A, Selhub J, Rowe JW, Seeman T (2002) Homocysteine levels and decline in physical function: MacArthur Studies of Successful Aging. Am J Med 113:537–542.CrossRefPubMedGoogle Scholar
  15. 15.
    Kuo HK, Liao KC, Leveille SG, Bean JF, Yen CJ, Chen JH, Yu YH, Tai TY (2007) Relationship of homocysteine levels to quadriceps strength, gait speed, and late-life disability in older adults. J Gerontol A Biol Sci Med Sci 62:434–439.CrossRefPubMedGoogle Scholar
  16. 16.
    Rolita L, Holtzer R, Wang C, Lipton R, Derby C, Verghese J (2010) Homocysteine and Mobility in Older Adults. J Am Geriatr Soc 58:545–550.CrossRefPubMedGoogle Scholar
  17. 17.
    Soumare A, Elbaz A, Ducros V, Tavernier B, Alperovitch A, Tzourio C (2006). Cross-sectional association between homocysteine and motor function in the elderly. Neurology 67:985–990.CrossRefPubMedGoogle Scholar
  18. 18.
    van Schoor NM, Swart KMA, Pluijm SMF, Visser M, Simsek S, Smulders Y, Lips P (2012). Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons. Eur J Clin Nutr 66:174–181.CrossRefPubMedGoogle Scholar
  19. 19.
    McDermott MM, Ferrucci L, Guralnik JM, Tian L, Green D, Liu K, Tan J, Liao Y, Pearce WH, Schneider JR, Ridker P, Rifai N, et al (2007) Elevated levels of inflammation, d-dimer, and homocysteine are associated with adverse calf muscle characteristics and reduced calf strength in peripheral arterial disease. J Am Coll Cardiol 50:897–905.CrossRefPubMedGoogle Scholar
  20. 20.
    Marengoni A, Cossi S, De Martinis M, Calabrese PA, Orini S, Grassi V (2004) Homocysteine and disability in hospitalized geriatric patients. Metabolism 53:1016–1020.CrossRefPubMedGoogle Scholar
  21. 21.
    Dhonukshe-Rutten RAM, Pluijm SMF, de Groot LCPG, Lips P, Smit JH, van Staveren WA (2005) Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people. J Bone Miner Res 20:921–929.CrossRefPubMedGoogle Scholar
  22. 22.
    Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K (2005) Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 293:1082–1088.CrossRefPubMedGoogle Scholar
  23. 23.
    Dierkes J, Jeckel A, Ambrosch A, Westphal S, Luley C, Boeing H (2001) Factors explaining the difference of total homocysteine between men and women in the European Investigation Into Cancer and Nutrition Potsdam study. Metabolism 50:640–645.CrossRefPubMedGoogle Scholar
  24. 24.
    Huisman M, Poppelaars J, van der Horst M, Beekman A, Brug J, van Tilburg T, Deeg D (2011) Cohort Profile: The Longitudinal Aging Study Amsterdam. Int J Epidemiol 40:868–876.CrossRefPubMedGoogle Scholar
  25. 25.
    Visser M, Fuerst T, Lang T, Salamone L, Harris TB (1999) Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, Aging, and Body Composition Study—Dual-Energy X-ray Absorptiometry and Body Composition Working Group. J Appl Physiol 87:1513–1520.PubMedGoogle Scholar
  26. 26.
    Schaap LA, Pluijm SMF, Deeg DJH, Visser M (2006) Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med 119:526–517.CrossRefPubMedGoogle Scholar
  27. 27.
    Viitasalo J, Era P, Leskinen A, Heikkinen E (1985) Muscular strength profiles and anthropometry in random samples of men aged 31–35, 51–55 and 71–75 years. Ergonomics 28:1563–1574.CrossRefGoogle Scholar
  28. 28.
    Avlund K, Schroll M, Davidsen M, Løvborg B, Rantanen T (1994) Maximal isometric muscle strength and functional ability in daily activities among 75-year-old men and women. Scand J Med Sci Sports 4:32–40.CrossRefGoogle Scholar
  29. 29.
    van Sonsbeek J (1988) Methodological and substantial aspects of the OECD indicator of chronic functional limitations. Maandbericht Gezondheid (CBS) 88:4–17.Google Scholar
  30. 30.
    Garretsen H. Probleemdrinken, prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden, theoretische overwegingen en onderzoek in Rotterdam. Lisse: Swets & Zeitlinger, 2003.Google Scholar
  31. 31.
    Stuck AE, Walthert JM, Nikolaus T, Bula CJ, Hohmann C, Beck JC (1999) Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med 48:445–469.CrossRefPubMedGoogle Scholar
  32. 32.
    Klinische Chemie. Kreatinine. In: VU medisch centrum, ed. Laboratoriumbepalingen 2012.Google Scholar
  33. 33.
    Myers AM, Holliday PJ, Harvey KA, Hutchinson KS (1993) Functional performance measures: are they superior to self-assessments? J Gerontol 48:M196–M206.CrossRefPubMedGoogle Scholar
  34. 34.
    Elshorbagy AK, Nurk E, Gjesdal CG, Tell GS, Ueland PM, Nygard O, Tverdal A, Vollset SE, Refsum H (2008) Homocysteine, cysteine, and body composition in the Hordaland Homocysteine Study: does cysteine link amino acid and lipid metabolism? Am J Clin Nutr 88:738–746.PubMedGoogle Scholar
  35. 35.
    Clark BC, Manini TM (2008) Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci 63:829–834.CrossRefPubMedGoogle Scholar
  36. 36.
    Leishear K, Ferrucci L, Lauretani F, Boudreau RM, Studenski SA, Rosano C, Abbate R, Gori AM, Corsi AM, Di Iorio A, Guralnik JM, Bandinelli S, et al (2012) Vitamin B12 and homocysteine levels and 6-year change in peripheral nerve function and neurological signs. J Gerontol A Biol Sci Med Sci 67:537–543.CrossRefPubMedGoogle Scholar
  37. 37.
    Mudd SH, Brosnan JT, Brosnan ME, Jacobs RL, Stabler SP, Allen RH, Vance DE, Wagner C (2007). Methyl balance and transmethylation fluxes in humans. Am J Clin Nutr 85:19–25.PubMedGoogle Scholar
  38. 38.
    Tarnopolsky MA (2000). Potential benefits of creatine monohydrate supplementation in the elderly. Curr Opin Clin Nutr Metab Care 3:497–502.CrossRefPubMedGoogle Scholar
  39. 39.
    Chatthanawaree W (2011) Biomarkers of cobalamin (vitamin B12) deficiency and its application. J Nutr Health Aging 15:227–231.CrossRefPubMedGoogle Scholar
  40. 40.
    Donders AR, van der Heijden GJMG, Stijnen T, Moons KGM (2006) Review: a gentle introduction to imputation of missing values. J Clin Epidemiol 59:1087–1091.CrossRefPubMedGoogle Scholar
  41. 41.
    Swart KMA, van Schoor NM, Blom HJ, Smulders YM, Lips P (2012) Homocysteine and the risk of nursing home admission and mortality in older persons. Eur J Clin Nutr 66:188–195.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2013

Authors and Affiliations

  • K. M. A. Swart
    • 1
    • 4
  • N. M. Van Schoor
    • 1
  • M. W. Heymans
    • 1
  • L. A. Schaap
    • 1
    • 2
  • M. Den Heijer
    • 3
  • P. Lips
    • 3
  1. 1.Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamthe Netherlands
  2. 2.Institute of Health Sciences, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care ResearchVU UniversityAmsterdamthe Netherlands
  3. 3.Department of Internal MedicineVU University Medical CenterAmsterdamthe Netherlands
  4. 4.Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamthe Netherlands

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