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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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The effect of B-vitamins on biochemical bone turnover markers and bone mineral density in osteoporotic patients: a 1-year double blind placebo controlled trial

Markus Herrmann1 / Natalia Umanskaya2 / Lydia Traber3 / Heinrich Schmidt-Gayk4 / Wolfgang Menke5 / Gerd Lanzer6 / Markus Lenhart7 / Johannes Peter Schmidt8 / Wolfgang Herrmann9

1ANZAC Research Institute, University of Sydney, Sydney NSW, Australia and Department of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Homburg/Saar, Germany

2Department of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Homburg/Saar, Germany

3Labor Limbach, Heidelberg, Germany

4Labor Limbach, Heidelberg, Germany and Unfortunately, Prof. Heinrich Schmidt-Gayk deceased while this work was in progress.

5Rehaklinik Saarschleife, Mettlach-Orscholz, Germany

6Orthopedic Studio, Völklingen, Germany

7Orthopedic Studio, St. Wendel, Germany

8Department of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Homburg/Saar, Germany

9Department of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Homburg/Saar, Germany

Corresponding author: Dr. Markus Herrmann, ANZAC Research Institute, Bone Research Program, Gate 3, Hospital Road, Concord, NSW 2139, Australia Phone: +61-2-9767-9165, Fax: +61-2-9767-9101,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 12, Pages 1785–1792, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2007.352, December 2007

Publication History

Received:
2007-08-15
Accepted:
2007-10-01
Published Online:
2007-12-08

Abstract

Background: Hyperhomocysteinemia is a new risk factor for osteoporosis. This study analyzed the effect of a homocysteine (HCY)-lowering treatment in osteoporotic individuals.

Methods: Osteoporotic subjects (n=47, 55–82 years) were treated with either a combination of 2.5 mg folate, 0.5 mg vitamin B12 and 25 mg vitamin B6 or placebo. Bone mineral density (BMD) at lumbar spine and hip was measured at baseline and after 1 year. Urinary desoxypyridinoline cross-links (DPD) and plasma levels of tartrate resistant acid phosphatase (TRAP), C-terminal cross-links of collagen I (CTx), pro-collagen type I N-terminal peptide (PINP) and osteocalcin (OC) were measured after 0, 4, 8 and 12 months.

Results: B-vitamin supplementation significantly reduced HCY (0 vs. 12 months: 13.6±4.8 vs. 8.9±2.4 μmol/L). Placebo treatment had no effect on HCY (0 vs. 12 months: 12.0±3.4 vs. 12.7±3.9μmol/L). BMD, TRAP, CTx, OC and PINP did not change throughout the study in both groups. Vitamin treatment decreased urinary DPD by –13% (p<0.01) after 8 and 12 months. In a sub-group analysis of hyperhomocysteinemic subjects (HCY>15 μmol/L, n=8), B-vitamin treatment tended to increase BMD at the lumbar spine, with a t-score from –2.7 to –1.7, and to decrease OC and PINP by approximately 50%.

Conclusions: B-vitamin supplementation had no consistent effects on bone turnover or BMD. However, the situation may be different in patients with hyperhomocysteinemia.

Clin Chem Lab Med 2007;45:1785–92.

Keywords: bone mineral density; C-terminal telopeptides of collagen I (CTx); folate; homocysteine; osteocalcin; pro-collagen type I N-terminal peptide (PINP); tartrate-resistant acid phosphatase (TRAP); urinary desoxypyridinoline cross-links (DPD); vitamin B6; vitamin B12

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