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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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Hyperhomocysteinemia is not associated with reduced bone quality in humans with hip osteoarthritis

Joerg H. Holstein1, 2 / Markus Herrmann3, 4 / Christina Splett1, 2 / Wolfgang Herrmann3 / Patric Garcia1, 2 / Tina Histing1, 2 / Moritz Klein1, 2 / Karsten Kurz5 / Thomas Siebel5 / Tim Pohlemann1 / Michael D. Menger2

1Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany

2Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany

3Department of Clinical Chemistry and Laboratory Medicine, University of Saarland, Homburg/Saar, Germany

4ANZAC Research Institute, University of Sydney, Sydney, Australia

5Department of Orthopaedic Surgery, Knappschaftskrankenhaus Püttlingen, Püttlingen, Germany

Corresponding author: Joerg H. Holstein, MD, Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, 66421 Homburg/Saar, Germany Phone: +49-6841-16-31501, Fax: +49-6841-16-31503,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 6, Pages 821–827, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.155, March 2010

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Background: Recent clinical and animal studies suggest that increased serum homocysteine (HCY) concentrations may be a risk factor for osteoporosis. In vitro studies showed that increasing HCY concentrations stimulate the activity of human osteoclasts. However, there is no data demonstrating that circulating HCY is related to structural and biomechanical properties of human bones. This study investigated the relationship between morphological as well as biomechanical bone properties and HCY serum concentrations in humans suffering from hip osteoarthritis (OA).

Methods: Fasting blood samples and femoral heads were obtained from 94 males and females who underwent hip arthroplasty due to OA. Bones were assessed by dual energy X-ray absorptiometry (DXA), biomechanical testing (indentation method), and histomorphometry. Blood was collected for measurement of HCY, folate, vitamin B6, and vitamin B12. Subjects were classified as hyperhomocysteinemic (>12  μmol/L, n=47) and normohomocysteinemic (<12 μmol/L, n=47) according to their serum HCY concentrations.

Results: Folate and vitamin B6, but not vitamin B12, were significantly lower in hyperhomocysteinemic subjects compared with controls. However, DXA, biomechanical testing, and histomorphometry did not reveal significant differences in bone quality between hyperhomocysteinemic subjects and controls.

Conclusions: The results of the present study do not indicate a significant relationship between circulating HCY concentrations and morphological or biomechanical bone properties in humans with OA of the hip.

Clin Chem Lab Med 2010;48:821–7.

Keywords: biomechanics; bone mineral density; B vitamins; histomorphometry; hyperhomocysteinemia

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