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.
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 B(12) and 25 mg vitamin B(6) 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 micromol/L). Placebo treatment had no effect on HCY (0 vs. 12 months: 12.0+/-3.4 vs. 12.7+/-3.9 micromol/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 mumol/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.
Herrmann
Markus
M
ANZAC Research Institute, University of Sydney, Sydney NSW, Australia. markusherr@aol.com
Umanskaya
Natalia
N
Traber
Lydia
L
Schmidt-Gayk
Heinrich
H
Menke
Wolfgang
W
Lanzer
Gerd
G
Lenhart
Markus
M
Peter Schmidt
Johannes
J
Herrmann
Wolfgang
W
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology*; D010919:Placebos; D014805:Vitamin B 12 / Q000097:blood; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000494:pharmacology*
D015415:Biomarkers; D010919:Placebos; D006710:Homocysteine; D014803:Vitamin B Complex; D005492:Folic Acid; D014805:Vitamin B 12