||The Relationship Between Serum Homocysteine Levels and Vertebral Fractures
NAGAI Takashi:筆頭著者:責任著者 ,
SAKAMOTO Keizo ,
TSUTSUI Sadaaki ,
KURODA Takuma ,
KANAZAWA TakaakiINAGAKI Katsunori
110 , 2015-06 , Showa University Society
Serum homocysteine and pentosidine levels have attracted attention as associated markers of bone quality, which affects bone strength. We examined the relationship of serum homocysteine levels with existing vertebral fractures and renal function. We evaluated 279 of 960 osteoporosis outpatients (12 men, 267 women; mean age, 72 years) whose serum homocysteine levels had been measured in our department. Using a glomerular filtration rate (GFR)-based chronic renal failure severity classification system, we divided patients into three groups: G1/G2, G3a/G3b/G4, and G5. We further divided the patients in the G1/G2 and G3a/G3b/G4 groups into two subgroups on the basis of the presence of fractures. Vertebral fractures were significantly more frequent when serum homocysteine levels were high in the G1/G2 group (P = 0.002). Serum homocysteine levels were lower in patients in the G1/G2 group than the G3a/G3b/G4 group despite the presence or absence of vertebral fractures (P < 0.001). Significant differences in serum homocysteine levels were also seen between patients with and without vertebral fractures in both the G1/G2 and G3a/G3b/G4 groups (P = 0.02). There were also significant correlations between GFR and serum homocysteine levels in both the G1/G2 and G3a/G3b/G4 groups (correlation coefficients, −0.43 and −0.65, respectively; P < 0.001). A negative correlation was observed between serum homocysteine levels and GFR in the G1/G2 and G3a/G3b/G4 groups, and we were able to reaffirm that serum homocysteine levels are affected by renal function. In the G1/G2 group, the prevalence of vertebral fractures was significantly higher in patients with high serum homocysteine levels. Even if renal function was poor, serum homocysteine levels were significantly higher in patients with vertebral fractures. Thus, serum homocysteine is a valid marker of bone quality.