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Homocysteine, an additional factor, is linked to osteoporosis in postmenopausal women with type 2 diabetes

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Abstract

We explored the relationship between plasma total homocysteine concentration and osteoporosis in postmenopausal patients with type 2 diabetes. Postmenopausal patients with type 2 diabetes (n = 258) were enrolled in a cross-sectional hospital-based study. Osteoporosis was documented by dual energy X-ray absorptiometry. Plasma total homocysteine concentration was measured using fluorescence polarization immunoassay. Risk factors for osteoporosis and determinants of homocysteine were obtained from blood samples and interviewer questionnaire. We found that plasma total homocysteine levels were higher in subjects with osteoporosis and diabetes than without [(9.5 ± 2.0) vs. (10.4 ± 2.4) μmol/l, p = 0.001]. The association of homocysteine with osteoporosis was independent of possible risk factors for osteoporosis in diabetes (e.g., duration of diabetes, HbA1c, body mass index, serum 25-hydroxyvitamin D, thiazolidinediones, and retinopathy) and determinants of homocysteine concentration (age, serum folate and vitamin B12, renal status, and biguanide use) [OR 1.40 (1.02–1.90), p = 0.036]. In addition, bone mineral density was closely correlated with homocysteine as a continuous variable after adjusting for age [r = −0.64 (−0.69 to −0.58), p = 0.002]. Furthermore, per increase of 5.0 μmol/l, plasma homocysteine was related to osteoporosis, after controlling for per unit increase of other factors [OR 1.42 (1.07–1.96), p = 0.027]. The optimal cut-off point for the plasma homocysteine level distinguishing diabetic patients with osteoporosis from without was 10.18 μmol/l. The results suggest that plasma total homocysteine concentration is independently associated with the occurrence of osteoporosis in postmenopausal patients with type 2 diabetes. Future prospective studies are warranted to clarify the relationship.

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Acknowledgments

We would like to thank National Natural Science Foundation (81070655) of China and Jiangsu Provincial Natural Science Foundation (BK2009441) of China for supporting this project. This work would not have been possible without the funding.

Conflict of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Diabetes and Osteoporosis Study Group, Endocrinology and Metabolism Department, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China

    Li Jianbo, Hongman Zhang, Lingfei Yan, Min Xie, Yan Mei & Chen Jiawei

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  1. Li Jianbo
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  2. Hongman Zhang
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  3. Lingfei Yan
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  4. Min Xie
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Correspondence to Li Jianbo.

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Jianbo, L., Zhang, H., Yan, L. et al. Homocysteine, an additional factor, is linked to osteoporosis in postmenopausal women with type 2 diabetes. J Bone Miner Metab 32, 718–724 (2014). https://doi.org/10.1007/s00774-013-0548-4

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  • DOI: https://doi.org/10.1007/s00774-013-0548-4

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