This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stone, K. L. Articles by Cummings, S. R. Search for Related Content PubMed PubMed Citation Articles by Stone, K. L. Articles by Cummings, S. R.

Low Serum Vitamin B-12 Levels Are Associated with Increased Hip Bone Loss in Older Women: A Prospective Study

Departments of Epidemiology and Biostatistics (D.C.B., S.R.C.) and Medicine (K.L.S., D.C.B.) and Division of Endocrinology and Metabolism (D.S.), University of California, San Francisco, California 94105

Address all correspondence and requests for reprints to: Dr. Katie L. Stone, University of California, 74 New Montgomery Street, Suite 600, San Francisco, California 94105. E-mail: kstone{at}psg.ucsf.edu.

The purpose of this study was to test whether low serum vitamin B-12 levels are associated with more rapid bone loss in elderly women. We archived sera and measured calcaneal bone mineral density (BMD) in community-dwelling white women, aged 65 yr and over, who participated in the Study of Osteoporotic Fractures. BMD of the hip and subregions was measured 2 yr later. Repeat measurements of calcaneal and hip BMD were obtained after 5.9 and 3.5 yr of follow-up, respectively. Serum vitamin B-12 assays were performed in 83 randomly selected participants with initial and repeat measurements of BMD who were not taking estrogen replacement therapy at baseline. After adjusting for age, weight, and clinic site, women with vitamin B-12 levels at or below 280 pg/ml (207.2 pmol/liter; lowest quintile) experienced an annual change of -1.6% (95% confidence interval, -2.4% to -0.8%) in total hip BMD, compared with -0.2% (-0.5% to 0.2%) in women with levels above 280 pg/ml (P = 0.003). Results were similar when subregions of the hip were analyzed separately. Serum vitamin B-12 levels were not significantly associated with calcaneal bone loss. We conclude that low serum vitamin B-12 levels are associated with increased rates of hip, but not calcaneal, bone loss in older women.

This work was supported by USPHS Grants AG-05407, AR-35582, AG-05394, AR-35584, and AR-35583.

Abbreviations: BAP, Bone-specific alkaline phosphatase; BMD, bone mineral density; 25(OH)D, 25-hydroxyvitamin D.

This article has been cited by other articles:

				R. R. McLean, P. F. Jacques, J. Selhub, L. Fredman, K. L. Tucker, E. J. Samelson, D. P. Kiel, L. A. Cupples, and M. T. Hannan Plasma B Vitamins, Homocysteine, and Their Relation with Bone Loss and Hip Fracture in Elderly Men and Women J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2206 - 2212. [Abstract] [Full Text] [PDF]

				T. J Green, J. A McMahon, C M. Skeaff, S. M Williams, and S. J Whiting Lowering homocysteine with B vitamins has no effect on biomarkers of bone turnover in older persons: a 2-y randomized controlled trial Am. J. Clinical Nutrition, February 1, 2007; 85(2): 460 - 464. [Abstract] [Full Text] [PDF]

				R. R. Miller, A. R. Cappola, M. D. Shardell, W. G. Hawkes, J. A. Yu-Yahiro, J. R. Hebel, and J. Magaziner Persistent changes in interleukin-6 and lower extremity function following hip fracture. J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2006; 61(10): 1053 - 1058. [Abstract] [Full Text] [PDF]

				M. Herrmann, T. Widmann, G. Colaianni, S. Colucci, A. Zallone, and W. Herrmann Increased Osteoclast Activity in the Presence of Increased Homocysteine Concentrations Clin. Chem., December 1, 2005; 51(12): 2348 - 2353. [Abstract] [Full Text] [PDF]

				G. Ravaglia, P. Forti, F. Maioli, L. Servadei, M. Martelli, N. Brunetti, L. Bastagli, D. Cucinotta, and E. Mariani Folate, But Not Homocysteine, Predicts the Risk of Fracture in Elderly Persons J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2005; 60(11): 1458 - 1462. [Abstract] [Full Text] [PDF]

				K. Stone, D. Sellmeyer, D. C. Bauer, and S. R. Cummings Authors' Response: Low Vitamin B12 and Bone Loss: A Role for Folate Deficiency J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4771 - 4772. [Full Text] [PDF]

				A. Cagnacci, M. Cannoletta, F. Baldassari, and A. Volpe Low Vitamin B12 and Bone Loss: A Role for Folate Deficiency J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4770 - 4771. [Full Text] [PDF]

				L. G. Raisz Homocysteine and Osteoporotic Fractures -- Culprit or Bystander? N. Engl. J. Med., May 13, 2004; 350(20): 2089 - 2090. [Full Text] [PDF]