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Lowering homocysteine with B vitamins has no effect on biomarkers of bone turnover in older persons: a 2-y randomized controlled trial^1,2,3

¹ From the Departments of Human Nutrition (TJG, JAM, and CMS) and Preventive and Social Medicine (SMW), University of Otago, Dunedin, New Zealand, and the College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada (SJW)

Background: In recent prospective studies, higher homocysteine concentrations were shown to be a risk factor for osteoporotic fractures in older persons. Supplements containing folate and vitamins B-12 and B-6 lower homocysteine concentrations.

Objective: The objective of the study was to determine in healthy older persons whether lowering homocysteine with B vitamins affects plasma biomarkers of bone turnover.

Design: Healthy older persons (n = 276; aged 65 y) were randomly assigned to receive either a daily supplement containing folate (1 mg), vitamin B-12 (500 µg), and vitamin B-6 (10 mg) or a placebo for 2 y. Of these participants, we selected 135 with baseline homocysteine concentrations >15.0 µmol/L, and we measured serum bone-specific alkaline phosphatase, a marker of bone formation, and bone-derived collagen fragments, a marker of bone resorption, at baseline and 2 y later.

Results: At 2 y, plasma homocysteine concentrations were 5.2 µmol/L (95% CI: 3.9, 6.6 µmol/L; P < 0.001) lower in the vitamin than in the placebo group. No significant differences were found in either serum bone-specific alkaline phosphatase (–0.3 µg/L; 95% CI: –2.8, 2.1 µg/L; P = 0.79) or bone-derived collagen fragments (–0.0 µg/L; 95% CI: –0.1, 0.1 µg/L; P = 0.76) between the vitamin and placebo groups, respectively, with 2 y of supplementation.

Conclusion: Supplementation with folate and vitamins B-6 and B-12 lowered plasma homocysteine but had no beneficial effect on bone turnover at the end of 2 y, as assessed by biomarkers of bone formation and resorption.

Key Words: Homocysteine • bone biomarkers • folate • vitamin B-12 • vitamin B-6 • clinical trial • older persons

This article has been cited by other articles:

				A. M. Sawka, J. G. Ray, Q. Yi, R. G. Josse, and E. Lonn Randomized Clinical Trial of Homocysteine Level Lowering Therapy and Fractures Arch Intern Med, October 22, 2007; 167(19): 2136 - 2139. [Full Text] [PDF]