title: Plasma level of homocysteine associated with severe vertebral fracture in postmenopausal women.
abstract: The aim of this cross-sectional cohort study was to clarify risk factors for severe vertebral fractures in postmenopausal Japanese women. Subjects were ambulatory volunteers age over 50 years who were recruited from a population of outpatients at a primary care institute. At registration, age, body mass index (BMI), bone mineral density (BMD), and present illness were investigated. Biochemical parameters including urinary levels of type I collagen cross-linked N-telopeptides (NTXs), and pentosidine and plasma levels of homocysteine were measured. Values were compared with different fracture grades (grade 0-3). A total of 1,475 postmenopausal women (66.6 ± 9.0 years) were included in the present study. Distributions of vertebral fracture grades were grade 1, 137 cases (9.3 %); grade 2, 124 cases (8.4 %); and grade 3, 162 cases (11.0 %). Age, BMI, BMD, NTX, pentosidine, and homocysteine were significantly associated with vertebral fracture in unadjusted analysis. In addition, a higher prevalence of hypertension was observed in patients with severe fracture. When comparing vertebral fracture grade 0 versus grade 2-3 by multiple regression analysis, pentosidine and homocysteine levels were a significant risk for moderate/severe vertebral fracture (odds ratio [OR] = 1.17, 95 % confidence interval [CI] 1.00-1.38, p = 0.049; OR = 1.22, 95 % CI 1.03-1.46, p = 0.013). Homocysteine levels were also a significant risk when comparing vertebral fracture grade 0 versus grade 3 (OR = 1.27, 95 % CI 1.04-1.58, p = 0.021). Plasma level of homocysteine was an independent risk for severe vertebral fractures.
authors.affiliation: Public Health Research Foundation, 1-1-7 Nishiwaseda, Shinjuku-ku, Tokyo 169-0051, Japan. kuroda@csp.or.jp
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kuroda
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Saito
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Shiraki
authors.forename: Masataka
authors.initials: M
authors.lastname: Shiraki
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood; D008875:Middle Aged; D016017:Odds Ratio; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000150:complications*; D015995:Prevalence; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D016103:Spinal Fractures / Q000097:blood* / Q000453:epidemiology
chemical_list: D006710:Homocysteine; D001120:Arginine; C062187:pentosidine; D008239:Lysine