Folate, but not homocysteine, predicts the risk of fracture in elderly persons

Giovanni Ravaglia, Paola Forti, Fabiola Maioli, Lucia Servadei, Mabel Martelli, Nicoletta Brunetti, Luciana Bastagli, Domenico Cucinotta, Erminia Mariani

Research output: Contribution to journalArticle

Abstract

Background. Recent prospective studies reported that increased plasma homocysteine levels are an independent predictor of osteoporotic fracture in elderly persons. These studies, however, did not take into account folate and vitamin B12, which are the major nutritional determinants of homocysteinemia. Methods. Incident osteoporotic fractures were assessed in 702 Italian participants aged 65-94 years with a mean follow-up of 4 years (1999/2000-2003/2004). A multivariable logistic regression model was used to study the relation of baseline plasma homocysteine, serum folate, and serum vitamin B12 with risk of fracture. Results. After adjustment for sociodemographic and clinical confounders, the odds ratio (OR) for each increase of 1 standard deviation in log-transformed plasma homocysteine was 1.39 (95% confidence interval [CI], 1.01-1.91), but decreased to 1.22 (95% CI, 0.85-1.74) after further adjustment for serum folate and vitamin B12. The corresponding multivariable-adjusted OR for hyperhomocysteinemia (plasma total homocysteine [tHcy] > 15 μmoL) was 1.58 (95% CI, 0.71-3.53). Participants in the lowest serum folate quartile (≤9.3 nmol/L) had an increased risk of fracture than did those in higher quartiles (multivariable-adjusted OR = 2.06; 95% CI. 1.02-4.18), but no dose-related protective effect for increasing serum folate levels was found (multivariable-adjusted OR = 0.84 for each increase of 1 standard deviation in log-transformed serum folate, 95% CI, 0.59-1.19). No independent association was found for serum vitamin B12. Conclusions. Low serum folate is responsible for the association between homocysteine and risk of osteoporotic fracture in elderly persons.

Original languageEnglish
Pages (from-to)1458-1462
Number of pages5
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume60
Issue number11
Publication statusPublished - Nov 2005

    Fingerprint

ASJC Scopus subject areas

  • Ageing

Cite this

Ravaglia, G., Forti, P., Maioli, F., Servadei, L., Martelli, M., Brunetti, N., Bastagli, L., Cucinotta, D., & Mariani, E. (2005). Folate, but not homocysteine, predicts the risk of fracture in elderly persons. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 60(11), 1458-1462.