title: Low serum folate and vitamin B-6 are associated with an altered cancellous bone structure in humans.
abstract: BACKGROUND
  Several clinical trials have reported B vitamins to be associated with osteoporosis.
  
  
  OBJECTIVE
  Our objective was to investigate whether low serum B vitamins are associated with altered structural and biomechanical properties of human bone.
  
  
  METHODS
  Femoral heads of 94 men and women who underwent hip arthroplasty were analyzed by using dual-energy X-ray absorptiometry (DXA), biomechanical testing (indentation method), and histomorphometry. In addition, blood was collected to measure serum concentrations of homocysteine, folate, vitamin B-6, vitamin B-12, the bone formation marker osteocalcin, and the bone resorption marker tartrate-resistant acid phosphatase (TRAP). Measurement outcomes were grouped according to subjects with high and low serum concentrations, respectively, of folate, vitamin B-6, and vitamin B-12 (n = 47 for each group).
  
  
  RESULTS
  Histomorphometric analysis showed a significantly lower trabecular thickness and trabecular area in subjects with low serum folate concentrations than in those with high serum folate concentrations and a significantly lower trabecular number in subjects with low serum vitamin B-6 concentrations than in those with high serum vitamin B-6 concentrations. In contrast, we found a comparable trabecular structure in subjects with high and low serum vitamin B-12 concentrations. DXA and biomechanical testing did not show significant differences between subjects with high and low serum B vitamin concentrations. Osteocalcin was significantly lowered in subjects with a low serum B vitamin concentration, whereas there was no association between serum B vitamins and TRAP.
  
  
  CONCLUSIONS
  The results of the present study indicate that low serum folate and vitamin B-6 concentrations, but not low serum vitamin B-12 concentrations, are associated with an altered morphology of human bone.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany. joerg.holstein@uks.eu
authors.forename: Joerg H
authors.initials: JH
authors.lastname: Holstein
authors.forename: Markus
authors.initials: M
authors.lastname: Herrmann
authors.forename: Christina
authors.initials: C
authors.lastname: Splett
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herrmann
authors.forename: Patric
authors.initials: P
authors.lastname: Garcia
authors.forename: Tina
authors.initials: T
authors.lastname: Histing
authors.forename: Stefan
authors.initials: S
authors.lastname: Graeber
authors.forename: Mei Fang
authors.initials: MF
authors.lastname: Ong
authors.forename: Karsten
authors.initials: K
authors.lastname: Kurz
authors.forename: Thomas
authors.initials: T
authors.lastname: Siebel
authors.forename: Michael D
authors.initials: MD
authors.lastname: Menger
authors.forename: Tim
authors.initials: T
authors.lastname: Pohlemann
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001827:Body Height; D001835:Body Weight; D015519:Bone Density; D001842:Bone and Bones / Q000473:pathology*; D005260:Female; D005270:Femur Head / Q000473:pathology*; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood; D026681:Vitamin B 6 Deficiency / Q000097:blood*
chemical_list: D005492:Folic Acid; D014805:Vitamin B 12