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Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden

Lewerin, C.; Nilsson-Ehle, H.; Jacobsson, S.; Johansson, H.; Sundh, V.; Karlsson, Magnus LU ; Ljunggren, O.; Lorentzon, M.; Kanis, J. A. and Lerner, U. H., et al. (2014) In Osteoporosis International 25(1). p.131-140
Abstract
In a population-based study on cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C. Cobalamin deficiency in elderlies may affect bone metabolism. This study aims to determine whether serum cobalamins or holotranscobalamin (holoTC; the metabolic active cobalamin) predict incident fractures in old men. Men participating in the Gothenburg part of the population-based Osteoporotic Fractures in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the... (More)
In a population-based study on cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C. Cobalamin deficiency in elderlies may affect bone metabolism. This study aims to determine whether serum cobalamins or holotranscobalamin (holoTC; the metabolic active cobalamin) predict incident fractures in old men. Men participating in the Gothenburg part of the population-based Osteoporotic Fractures in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the present study (n = 790; age range, 70-81 years). During an average follow-up of 5.9 years, 110 men sustained X-ray-verified fractures including 45 men with clinical vertebral fractures. The risk of fracture (adjusted for age, smoking, BMI, BMD, falls, prevalent fracture, tHcy, cystatin C, 25-OH-vitamin D, intake of calcium, and physical activity (fully adjusted)), increased per each standard deviation decrease in cobalamins (hazard ratio (HR), 1.38; 95 % confidence intervals (CI), 1.11-1.72) and holoTC (HR, 1.26; 95 % CI, 1.03-1.54), respectively. Men in the lowest quartile of cobalamins and holoTC (fully adjusted) had an increased risk of all fracture (cobalamins, HR = 1.67 (95 % CI, 1.06-2.62); holoTC, HR = 1.74 (95 % CI, 1.12-2.69)) compared with quartiles 2-4. No associations between folate or tHcy and incident fractures were seen. We present novel data showing that low levels of holoTC and cobalamins predicting incident fracture in elderly men. This association remained after adjustment for BMI, BMD, tHcy, and cystatin C. However, any causal relationship between low cobalamin status and fractures should be explored in a prospective treatment study. (Less)
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published
subject
keywords
Cobalamins, Holotranscobalamin, Homocysteine, Fractures, Men
in
Osteoporosis International
volume
25
issue
1
pages
131 - 140
publisher
Springer
external identifiers
  • wos:000329106000011
  • scopus:84891888671
ISSN
1433-2965
DOI
10.1007/s00198-013-2527-y
language
English
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yes
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ecacc40b-a567-4ec0-b6cf-09e918012077 (old id 4327099)
date added to LUP
2014-03-03 08:06:20
date last changed
2017-01-01 05:41:22
@article{ecacc40b-a567-4ec0-b6cf-09e918012077,
  abstract     = {In a population-based study on cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C. Cobalamin deficiency in elderlies may affect bone metabolism. This study aims to determine whether serum cobalamins or holotranscobalamin (holoTC; the metabolic active cobalamin) predict incident fractures in old men. Men participating in the Gothenburg part of the population-based Osteoporotic Fractures in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the present study (n = 790; age range, 70-81 years). During an average follow-up of 5.9 years, 110 men sustained X-ray-verified fractures including 45 men with clinical vertebral fractures. The risk of fracture (adjusted for age, smoking, BMI, BMD, falls, prevalent fracture, tHcy, cystatin C, 25-OH-vitamin D, intake of calcium, and physical activity (fully adjusted)), increased per each standard deviation decrease in cobalamins (hazard ratio (HR), 1.38; 95 % confidence intervals (CI), 1.11-1.72) and holoTC (HR, 1.26; 95 % CI, 1.03-1.54), respectively. Men in the lowest quartile of cobalamins and holoTC (fully adjusted) had an increased risk of all fracture (cobalamins, HR = 1.67 (95 % CI, 1.06-2.62); holoTC, HR = 1.74 (95 % CI, 1.12-2.69)) compared with quartiles 2-4. No associations between folate or tHcy and incident fractures were seen. We present novel data showing that low levels of holoTC and cobalamins predicting incident fracture in elderly men. This association remained after adjustment for BMI, BMD, tHcy, and cystatin C. However, any causal relationship between low cobalamin status and fractures should be explored in a prospective treatment study.},
  author       = {Lewerin, C. and Nilsson-Ehle, H. and Jacobsson, S. and Johansson, H. and Sundh, V. and Karlsson, Magnus and Ljunggren, O. and Lorentzon, M. and Kanis, J. A. and Lerner, U. H. and Cummings, S. R. and Ohlsson, C. and Mellstrom, D.},
  issn         = {1433-2965},
  keyword      = {Cobalamins,Holotranscobalamin,Homocysteine,Fractures,Men},
  language     = {eng},
  number       = {1},
  pages        = {131--140},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden},
  url          = {http://dx.doi.org/10.1007/s00198-013-2527-y},
  volume       = {25},
  year         = {2014},
}