血浆同型半胱氨酸水平、甲基化能力与骨质疏松性骨折事件的关联。

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

机构信息

Erasmus MC, Department of Internal Medicine, Postbus 2040, 3000 CA Rotterdam, The Netherlands.

出版信息

Bone. 2012 Jun;50(6):1401-5. doi: 10.1016/j.bone.2012.03.013. Epub 2012 Mar 21.

DOI:10.1016/j.bone.2012.03.013

PMID:22465697

Abstract

BACKGROUND

An elevated level of plasma homocysteine (Hcy) is a known risk factor for osteoporotic fractures. In addition, Hcy is related to DNA-methylation metabolism. To determine whether the association between Hcy and fractures is explained by an altered methylation capacity, we investigated the associations between levels of s-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) and fracture risk.

METHODS

We studied 503 females aged 55 years 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 7.0 years. Cox proportional hazards analysis and linear regression were used to assess relationships between plasma metabolite levels, incident osteoporotic fractures and BMD.

RESULTS

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).

CONCLUSION

Since SAM, 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 Hcy and fractures.

摘要

背景

血浆同型半胱氨酸（Hcy）水平升高是骨质疏松性骨折的已知危险因素。此外，Hcy 与 DNA 甲基化代谢有关。为了确定 Hcy 与骨折之间的关联是否与甲基化能力改变有关，我们研究了 s-腺苷甲硫氨酸（SAM）和 S-腺苷同型半胱氨酸（SAH）水平与骨折风险之间的关系。

方法

我们研究了来自鹿特丹研究（RS）的 503 名 55 岁及以上的女性，她们的血浆 Hcy、SAM 和 SAH 水平均进行了测量。使用 DXA 评估髋部骨密度（BMD）。在平均 7.0 年的随访期间记录了新发骨折情况。使用 Cox 比例风险分析和线性回归来评估血浆代谢物水平与新发骨质疏松性骨折和 BMD 之间的关系。

结果

在总共 3502 人年的随访期间，103 名受试者发生了至少一次骨质疏松性骨折。虽然骨质疏松性骨折的发生率与 Hcy 的四分位间距相关（p=0.047），但与 SAM、SAH 或 SAM/SAH 比值的四分位间距无关（所有趋势 p 值均>0.6）。逐步线性回归显示，SAM/SAH 比值，而不是 Hcy，与髋部 BMD 独立相关（β=0.073，p=0.025）。