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Gehalte aan homocysteïne een
aanwijzing voor heupbreuken bij ouderen.*
Uit een studie onder ruim 2000 ouderen blijkt dat
het bloedgehalte aan homocysteïne een graadmeter is voor mogelijke botbreuken.
Mannen met een verhoogd homocysteïne hadden 4x, en vrouwen 2x
meer kans op het breken van een heup dan personen met lage waarden aan
homocysteïne.
Homocysteine as a
Predictive Factor for Hip Fracture in Older Persons
Robert R. McLean,
M.P.H., Paul F. Jacques, D.Sc., Jacob Selhub, Ph.D., Katherine L. Tucker, Ph.D.,
Elizabeth J. Samelson, Ph.D., Kerry E. Broe, M.P.H., Marian T. Hannan, D.Sc., L.
Adrienne Cupples, Ph.D., and Douglas P. Kiel, M.D.
Background The increased prevalence of osteoporosis
among people with homocystinuria suggests that a high serum
homocysteine concentration may weaken bone by interfering with
collagen cross-linking, thereby increasing the risk of osteoporotic
fracture. We examined the association between the total homocysteine
concentration and the risk of hip fracture in men and women enrolled
in the Framingham Study.
Methods We studied 825 men and 1174 women, ranging
in age from 59 to 91 years, from whom blood samples had been obtained
between 1979 and 1982 to measure plasma total homocysteine. The
participants in our study were followed from the time that the sample
was obtained through June 1998 for incident hip fracture.
Sex-specific, age-adjusted incidence rates of hip fracture were
calculated for quartiles of total homocysteine concentrations. Cox
proportional-hazards regression was used to calculate hazard ratios
for quartiles of homocysteine values.
Results The mean (±SD) plasma total homocysteine
concentration was 13.4±9.1 µmol per liter in men and 12.1±5.3
µmol per liter in women. The median duration of follow-up was
12.3 years for men and 15.0 years for women. There were 41 hip
fractures among men and 146 among women. The age-adjusted incidence
rates per 1000 person-years for hip fracture, from the lowest to the
highest quartile for total homocysteine, were 1.96 (95 percent
confidence interval, 0.52 to 3.41), 3.24 (0.97 to 5.52), 4.43 (1.80
to 7.07), and 8.14 (4.20 to 12.08) for men and 9.42 (5.72 to 13.12),
7.01 (4.29 to 9.72), 9.58 (6.42 to 12.74), and 16.57 (11.84 to 21.30)
for women. Men and women in the highest quartile had a greater risk
of hip fracture than those in the lowest quartile — the risk was
almost four times as high for men and 1.9 times as high for women.
Conclusions These findings suggest that the homocysteine concentration, which is easily modifiable by means of dietary intervention, is an important risk factor for hip fracture in older persons.