Homocysteine as a Predictive Factor for Hip Fracture in Older Persons

This article examines the association between the total homocysteine concentration and the risk of hip fracture in Framingham Study participants during a median follow-up period of 12.3 years for men and 15.0 years for women. Age-adjusted incidence rates for hip fracture increased progressively from the lowest to the highest quartile of homocysteine. For men in the highest quartile, the risk increased by a factor of almost four, and for women, by 1.9. The association between the total homocysteine concentration and the risk of hip fracture in Framingham Study participants. Homocysteine is an amino acid intermediate formed during the metabolism of methionine. Homocystinuria, a rare autosomal recessive biochemical abnormality, causes elevated plasma concentrations of homocysteine and severe occlusive vascular disease. 1 This observation has led to studies that implicate plasma homocysteine as a risk factor for cardiovascular disease. 2 , 3 In patients with homocystinuria, there is an increased prevalence of skeletal deformities, including osteoporosis, 1 , 4 , 5 which is a primary risk factor for hip fracture. Thus, elevated plasma homocysteine concentrations may be associated with osteoporosis and may increase the risk of hip fracture, which can lead to substantial disability, 6 high medical costs, . . .