TY - JOUR
T1 - Homocysteine levels and risk of hip Fracture in postmenopausal women
AU - Leboff, Meryl S.
AU - Narweker, Rupali
AU - Lacroix, Andrea
AU - Wu, Lieling
AU - Jackson, Rebecca
AU - Lee, Jennifer
AU - Bauer, Douglas C.
AU - Cauley, Jane
AU - Kooperberg, Charles
AU - Lewis, Cora
AU - Thomas, Asha M.
AU - Cummings, Steven
N1 - Funding Information:
Funding support for this research was provided by the National Institutes of Health (NIH)-WHI Vanguard Center Grant (WHI-9219E) and NIH ROI Hip Fracture Umbrella Study. The WHI program is funded by the National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services. Support was also provided by NIH Grant Ancillary Study 90: 5 RO1 AR048919-04 and WHI Federal Contract NO1-WH-2-2110.
PY - 2009/4
Y1 - 2009/4
N2 - Background: Recent studies suggest that high homocysteine levels are associated with an increased risk of fractures. Homocysteine levels are known to be influenced by vitamin B and folate supply or status, and poor renal function can result in higher levels independent of nutritional adequacy. Objective: The aim of the study was to determine the associations between fasting homocysteine levels and incident hip fractures, and the effects of other factors on hip fracture risk. Design: We conducted a case-control study in the Women's Health Initiative Observational Study, a study of postmenopausal women (n = 93,676) recruited in the United States. We selected 400 incident cases of hip fracture and 400 controls matched on age, ethnicity, and blood draw date among women not on osteoporosis therapies. Outcome measures included physician-adjudicated, incident hip fractures. Baseline lifestyle and nutritional questionnaires were performed. Results: The risk of hip fracture increased 1.38-fold [95% confidence interval (CI), 1.14, 1.66] for each sd increase in serum homocysteine level after adjustment for fracture risk factors. This association was not affected by adjustment for dietary folate, B6, or B12 intake, but it diminished after adjustment for cystatin-C level (odds ratio, 1.08; 95% CI, 0.66-1.79), a measure of renal function not affected by muscle mass. Among women in the highest quartile of homocysteine and cystatin-C compared to those without elevations in either biomarker, the risk of hip fracture was substantially elevated (odds ratio, 2.8; 95% CI, 1.61-4.87). Conclusions: This study indicates that high homocysteine levels are associated with an increased risk of hip fracture, which could be accounted for by poor renal function.
AB - Background: Recent studies suggest that high homocysteine levels are associated with an increased risk of fractures. Homocysteine levels are known to be influenced by vitamin B and folate supply or status, and poor renal function can result in higher levels independent of nutritional adequacy. Objective: The aim of the study was to determine the associations between fasting homocysteine levels and incident hip fractures, and the effects of other factors on hip fracture risk. Design: We conducted a case-control study in the Women's Health Initiative Observational Study, a study of postmenopausal women (n = 93,676) recruited in the United States. We selected 400 incident cases of hip fracture and 400 controls matched on age, ethnicity, and blood draw date among women not on osteoporosis therapies. Outcome measures included physician-adjudicated, incident hip fractures. Baseline lifestyle and nutritional questionnaires were performed. Results: The risk of hip fracture increased 1.38-fold [95% confidence interval (CI), 1.14, 1.66] for each sd increase in serum homocysteine level after adjustment for fracture risk factors. This association was not affected by adjustment for dietary folate, B6, or B12 intake, but it diminished after adjustment for cystatin-C level (odds ratio, 1.08; 95% CI, 0.66-1.79), a measure of renal function not affected by muscle mass. Among women in the highest quartile of homocysteine and cystatin-C compared to those without elevations in either biomarker, the risk of hip fracture was substantially elevated (odds ratio, 2.8; 95% CI, 1.61-4.87). Conclusions: This study indicates that high homocysteine levels are associated with an increased risk of hip fracture, which could be accounted for by poor renal function.
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U2 - 10.1210/jc.2008-1777
DO - 10.1210/jc.2008-1777
M3 - Article
C2 - 19174498
AN - SCOPUS:65249135662
VL - 94
SP - 1207
EP - 1213
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 4
ER -