title: Plasma homocysteine level is a risk factor for osteoporotic fractures in elderly patients.
abstract: OBJECTIVE
  To study the relationship of plasma homocysteine (Hcy), bone turnover biomarkers (BTB), and bone mineral density (BMD) with osteoporotic fracture (OPF) in elderly people.
  
  
  METHODS
  Eighty-two patients (aged 65 years or older) admitted to our orthopedics department between October 2014 and May 2015 were randomly divided into three groups: 1) OPF group: 39 cases with the mean age 81.82±5.49 years, which included 24 females and 15 males; 2) high-energy fracture (HEF) group: 22 cases with the mean age 78.88±5.75 years, which included 16 females and six males; 3) non-bone-fracture group: 21 cases with mean age 79.75±5.47 years without bone fracture, which included 14 females and seven males. Plasma Hcy, BTB, and BMD were measured. Analysis of variance and multiple regression analysis were used in the statistical analysis.
  
  
  RESULTS
  There was no significant difference in either age or sex among the three groups. There were significant differences in plasma Hcy and hip BMD between the OPF and HEF groups; there was also significant difference in plasma Hcy, 25-(OH) Vit D, and hip BMD between the OPF and non-fracture groups. There was no difference in lumbar spine BMD between the OPF group and the other two groups. There was no significant difference in plasma Hcy, 25-(OH) Vit D, hip or lumbar spine BMD between the HEF and non-fracture group. There was no significant difference in procollagen type I N-propeptide of type I collagen, serum C-terminal cross-linking telopeptide of type I collagen, and parathyroid hormone among the three groups. Plasma Hcy was linearly correlated with age and serum C-terminal cross-linking telopeptide of type I collagen, but not correlated with either hip or lumbar spine BMD or any other BTBs.
  
  
  CONCLUSIONS
  In this study, we found that the plasma Hcy level in elderly patients with OPF is higher than that of nonosteoporotic patients. It is not correlated with BMD, but positively correlated with bone resorption markers. An increased Hcy level appears to be a risk factor for OPFs in elderly people.
authors: Department of Orthopedics.
authors: Yuefeng
authors: Y
authors: Zhu
authors: Department of Pharmacy.
authors: Jie
authors: J
authors: Shen
authors: Department of Osteoporosis, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.
authors: Qun
authors: Q
authors: Cheng
authors: Department of Orthopedics.
authors: Yongqian
authors: Y
authors: Fan
authors: Department of Orthopedics.
authors: Weilong
authors: W
authors: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015519:Bone Density; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000097:blood* / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D006710:Homocysteine
keywords: bone mineral density; bone turnover marker; elderly patient; fracture; homocysteine; osteoporosis