Osteoporotic Vertebral Fracture Risk in the Spine

Do Homocysteine, Vitamin B12, and Folate Decrease Fracture Risk?

Do homocysteine, vitamin B12, and folate impact the prevalence of asymptomatic osteoporotic vertebral fractures (VFs)—specifically VFs in the lumbar spine and proximal femur—in postmenopausal women? This is exactly what researchers examined in a study.
Medical team working together, all looking at a laptop computerThe research team obtained lateral VFA images and scans of the participants’ lumbar spine and proximal femur.Results of their study appeared online in the article “Homocysteine, folate, and vitamin B12 levels and vertebral fracture risk in postmenopausal women.” It appears in an issue of the Journal of Clinical Densitometry.

There were a total of 188 postmenopausal women who participated in the study. Mean age of the women was 57.9±8.5 (41 to 91) years old; mean weight was74.4±13.5 (38 to 150) kg; and mean body mass index was 30.4±5.2 (17.1 to 50.7) kg/m2.

The research team used vertebral fracture assessment (VFA) using a LUNAR Prodigy bone densitometer (a GE Healthcare product). They obtained lateral VFA images and scans of the participants’ lumbar spine and proximal femur.

Vertebral fractures in the women were defined using a Genant’s semi-quantitative approach and morphometry.

The researchers found that 58 of the patients (30.9%) had densitometric osteoporosis.

Using VFA, researchers found that 76 of the participants (40.4%) had vertebral fractures—61 had grade 1 VFs and 15 had grades 2 or 3 VFs.

The research team divided the women into 3 groups—absence of VFs, grade 1 VFs, and grades 2 or 3 VFs. They noted that no statistical difference was observed between these 3 groups in regard to biological parameters.

When comparing the women according to quartiles of homocysteine levels, the women in the highest quartile were older and had a lower bone mineral density (BMD). On the other hand, the prevalence of VFs was not statistically different from that of the participants who were in the other quartile groups.

Researchers performed stepwise regression analysis. The analysis showed that homocysteine was not independently linked to VFs. However, the presence of VFs was mainly related to the women’s osteoporotic status.

They observed a weak link between hyperhomocysteinemia and low BMD and a trend of higher prevalence of grades 2 or 3 VFs. But the study did not confirm that homocysteine, vitamin B12, and folate are important determinants when it comes to prevalence of asymptomatic osteoporotic vertebral fractures—including VFs of the spine—in postmenopausal women.

Updated on: 03/09/18
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