Zhang Hongxiu, Tao Xincheng, Wu Jie
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China.
Arch Gynecol Obstet. 2014 May;289(5):1003-9. doi: 10.1007/s00404-013-3075-6. Epub 2013 Nov 6.
The relationship of homocysteine (Hcy), folate, and vitamin B12 with bone mineral density (BMD) has been investigated in postmenopausal women. However, the relationship is still controversial.
To evaluate the association of Hcy, folate, vitamin B12 and BMD in postmenopausal women with a meta-analysis.
We searched for all published articles indexed in Medline (1950-2012), Embase (1974-2012), and China National Knowledge Infrastructure (1994-2012). Any case-control or cohort study relating to Hcy, vitamin B12, folate, and BMD was included, and the data were extracted independently by two reviewers. Criteria for inclusion were the assessment of Hcy, vitamin B12, folate, and BMD in postmenopausal women as outcomes. We performed this meta-analysis with Review Manager 5.1 software. Odds ratios and 95 % confidence intervals (CI) were used to evaluate the results.
Six eligible studies were selected for meta-analysis. Our analysis suggested that vitamin B12 and Hcy levels were significantly higher in postmenopausal osteoporosis (PMOP) group than that in controls (P = 0.007, <0.05; 95 % CI 3.06-19.38 and P = 0.0003, <0.05; 95 % CI 0.75-2.52, respectively). Folate level was lower in PMOP group than that in controls, but this difference was not statistically significant (P = 0.09, 95 % CI -3.33 to 0.25).
Hcy and vitamin B12, but not folate, were related to BMD in PMOP. Extra vitamin B12 may not play a protective role for osteoporosis in postmenopausal women. Future studies are needed to confirm them, especially the relationship between increased vitamin B12 and BMD.
绝经后女性中同型半胱氨酸（Hcy）、叶酸和维生素B12与骨密度（BMD）的关系已得到研究。然而，这种关系仍存在争议。
通过荟萃分析评估绝经后女性中Hcy、叶酸、维生素B12与骨密度之间的关联。
我们检索了Medline（1950 - 2012年）、Embase（1974 - 2012年）和中国知网（1994 - 2012年）中所有已发表的文章。纳入任何与Hcy、维生素B12、叶酸和骨密度相关的病例对照研究或队列研究，数据由两名审阅者独立提取。纳入标准是以绝经后女性中Hcy、维生素B12、叶酸和骨密度的评估作为研究结果。我们使用Review Manager 5.1软件进行这项荟萃分析。采用比值比和95%置信区间（CI）来评估结果。
六项符合条件的研究被选入荟萃分析。我们的分析表明，绝经后骨质疏松症（PMOP）组的维生素B12和Hcy水平显著高于对照组（P = 0.007，<0.05；95% CI 3.06 - 19.38和P = 0.0003，<0.05；95% CI 0.75 - 2.52）。PMOP组的叶酸水平低于对照组，但这种差异无统计学意义（P = 0.09，95% CI -3.33至0.25）。
在PMOP中，Hcy和维生素B12与骨密度有关，而叶酸无关。额外补充维生素B12可能对绝经后女性的骨质疏松症无保护作用。需要进一步的研究来证实这些结果，尤其是维生素B12升高与骨密度之间的关系。
