The association between plasma homocysteine levels, methylation capacity and incident osteoporotic fractures

Bone, 05/11/2012

Since s–adenosylmethionine (SAM), S–adenosylhomocysteine (SAH) and SAM/SAH–ratio were not associated with osteoporotic fractures, alterations in methylation capacity most likely do not appear to be an important factor in the association between homocysteine (Hcy) and fractures.


  • The authors studied 503 females aged 55years and over from the Rotterdam Study (RS) in whom plasma Hcy, SAM and SAH levels were measured.
  • Bone mineral density (BMD) at the hip was assessed using DXA.
  • Incident fractures were recorded over a mean period of 7.0years.
  • Cox proportional hazards analysis and linear regression were used to assess relationships between plasma metabolite levels, incident osteoporotic fractures and BMD.


  • Over a total of 3502 person–years of follow–up, 103 subjects sustained at least one osteoporotic fracture.
  • Whereas incidence of osteoporotic fractures was associated with quartiles of Hcy (p=0.047), it was not associated with quartiles of SAM, SAH or SAM/SAH–ratio (all p for trend>0.6).
  • Stepwise linear regression showed that SAM/SAH–ratio, but not Hcy, was independently associated with hip BMD (β=0.073, p=0.025).

Print Article Summary Cat 2 CME Report