Low serum folate and vitamin B-6 are associated with an altered cancellous bone structure in humans.
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.
Holstein
Joerg H
JH
Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany. joerg.holstein@uks.eu
Herrmann
Markus
M
Splett
Christina
C
Herrmann
Wolfgang
W
Garcia
Patric
P
Histing
Tina
T
Graeber
Stefan
S
Ong
Mei Fang
MF
Kurz
Karsten
K
Siebel
Thomas
T
Menger
Michael D
MD
Pohlemann
Tim
T
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*
D005492:Folic Acid; D014805:Vitamin B 12