2013-05-24T12:32:05Z http://repub.eur.nl/oai

oai:repub.eur.nl/res/pub/8452 2012-11-14T12:33:37Z org:9834 org:9797 org:9831 org:9830 org:9803 org:9755 org:9746 org:9818 access:open type:article

urn:NBN:nl:ui:15-1765/8452 2012-11-14T12:33:37 mods http://hdl.handle.net/1765/8452 hdl:1765/8452 urn:NBN:nl:ui:15-1765/8452 Homocysteine levels and the risk of osteoporotic fracture text article http://hdl.handle.net/1765/8452 http://repub.eur.nl/res/pub/8452/15141041.pdf application/pdf Filesize: 130 KB born digital BACKGROUND: Very high plasma homocysteine levels are characteristic of homocystinuria, a rare autosomal recessive disease accompanied by the early onset of generalized osteoporosis. We therefore hypothesized that mildly elevated homocysteine levels might be related to age-related osteoporotic fractures. METHODS: We studied the association between circulating homocysteine levels and the risk of incident osteoporotic fracture in 2406 subjects, 55 years of age or older, who participated in two separate prospective, population-based studies. In the Rotterdam Study, there were two independent cohorts: 562 subjects in cohort 1, with a mean follow-up period of 8.1 years; and 553 subjects in cohort 2, with a mean follow-up period of 5.7 years. In the Longitudinal Aging Study Amsterdam, there was a single cohort of 1291 subjects, with a mean follow-up period of 2.7 years. Multivariate Cox proportional-hazards regression models were used for analysis of the risk of fracture, with adjustment for age, sex, body-mass index, and other characteristics that may be associated with the risk of fracture or with increased homocysteine levels. RESULTS: During 11,253 person-years of follow-up, osteoporotic fractures occurred in 191 subjects. The overall multivariable-adjusted relative risk of fracture was 1.4 (95 percent confidence interval, 1.2 to 1.6) for each increase of 1 SD in the natural-log-transformed homocysteine level. The risk was similar in all three cohorts studied, and it was also similar in men and women. A homocysteine level in the highest age-specific quartile was associated with an increase by a factor of 1.9 in the risk of fracture (95 percent confidence interval, 1.4 to 2.6). The associations between homocysteine levels and the risk of fracture appeared to be independent of bone mineral density and other potential risk factors for fracture. CONCLUSIONS: An increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women. Meurs, J.B.J. van Meurs, van Joyce aut Jonge, R. de Jonge, de Robert aut Lindemans, J. Lindemans Jan aut Groot, L.C.P.M.G. Groot, de Lisette aut Uitterlinden, A.G. Uitterlinden André aut Witteman, J.C.M. Witteman Jacqueline aut Pols, H.A.P. Pols Huib aut Lips, P. Lips Paul aut Breteler, M.M.B. Breteler Monique aut Dhonukshe-Rutten, R.A. Dhonukshe-Rutten R.A. aut Pluijm, S.M. Pluijm Saskia aut Klift, M. van de Klift, van de Marjolein aut Leeuwen, J.P.T.M. van Leeuwen, van Hans aut Hofman, A. Hofman Albert aut 176589759 184900085 298680955 104713968 07101876X 073522368 108068412 234830166 073520438 069249733 Erasmus MC: University Medical Center Rotterdam Supporting host sht en English New England Journal of Medicine 0028-4793 2004-01-01 Male Aged Cohort Studies Female Humans Middle aged Research Support, Non-U.S. Gov't Follow-Up Studies Risk Factors Homocysteine/*blood Proportional Hazards Models Risk Bone Density Fractures, Bone/*etiology Hyperhomocysteinemia/*complications Osteoporosis/*blood/complications Erasmus University Rotterdam oai:repub.eur.nl/res/pub/8452 IR OAIPMH feed (http://repub.eur.nl/oai) 2007-01-30T08:01:25Z 2011-11-23T09:59:13Z http://purl.org/eprint/accessRights/OpenAccess