Yaşlılarda Serum Homosistein Düzeyi ile Osteoporoz Arasında İlişki Var mı?

Year 2021, , 9 - 14, 30.04.2021

Mehmet Selman Öntan , Özge Dokuzlar

https://doi.org/10.47141/geriatrik.919473

Cited By: 1

Abstract

Amaç: Osteoporoz ilerleyen yaşla sıklığı artan, çok sayıda morbidite, mortalite ve artan sağlık harcamalarına yol açan bir sorundur. Homosistinüri hastalarında erken yaşta görülen osteoporoz serum homosistein düzeyi ile osteoporoz arasında ilişki olabileceğini düşündürmüştür. Bu çalışmanın amacı, yaşlı erişkinlerde serum homosistein düzeyi ile osteoporoz arasında herhangi bir ilişki olup olmadığının araştırılmasıdır.

Gereç ve Yöntemler: Çalışmaya 65 yaş ve üzeri dosyalarında eş zamanlı dual enerji X-ray absorbsiyometri (DEXA) ve serum homosistein seviyesi olan 168 hasta dahil edildi. Hastaların dosyalarında yer alan demografik veriler, DEXA ölçümleri, serum homosistein düzeyi ve laboratuvar analizleri kaydedildi. Retrospektif ve kesitsel bir çalışma olarak dizayn edildi.

Bulgular: Katılımcıların yaş ortalaması 75,79±7,40 yıl ve %74,4’ü kadın idi. 67 hastada osteoporoz, 80 hastada osteopeni saptandı. Kontrol, osteopeni ve osteoporoz gruplarında serum homosistein düzeyleri sırası ile 15,01±5,84, 15,42±7,09 ve 15,61±7,88 mmol/L idi. Vitamin B12, Folat, Vitamin D ve TSH düzeyleri gruplar arasında anlamlı fark yoktu. Gruplar arasında yaş, cinsiyet ve vücut kitle indekslerinin karıştırıcı etkileri ortadan kaldırıldıktan sonra artmış serum homosistein düzeyleri ile osteoporoz arasında anlamlı ilişki saptandı (OR:1,114; p<0,05). Diğer sonuçlarda ise istatistiksel anlamlı bir değişiklik olmadı.

Sonuç: Yüksek serum homosistein düzeylerinin yaşlı erişkinlerde sık ve önemli bir sorun olan osteoporoz riskini artırdığı saptanmıştır. Bu sonuçların desteklenmesi ve nedenlerinin aydınlatılması için prospektif çalışmalara ihtiyaç duyulmaktadır.

Keywords

homosistein, osteopeni, osteoporoz, yaşlı

Supporting Institution

yoktur

Is There a Relationship Between Serum Homocysteine Level and Osteoporosis in Older Adults?

Abstract

Aim: Osteoporosis is an important clinical condition that is quite common in older adults and is related to many morbidities, mortality, and increased healthcare costs. Early osteoporosis in patients with homocystinuria suggests that there may be a relationship between serum homocysteine level and osteoporosis. The aim of this study is to investigate whether there is any relationship between serum homocysteine level and osteoporosis in older adults.

Material and Methods: The study included 168 patients aged 65 years and older who have simultaneous dual-energy X-ray absorptiometry (DEXA) and serum homocysteine levels. Demographic data, DEXA measurements, serum homocysteine level, and laboratory analysis in the patients' files were recorded. The study was designed as a retrospective and cross-sectional study.

Results: The average age of the participants was 75.79 ± 7.40 years, and 74.4% of them were women. Osteoporosis and osteopenia were diagnosed in 67 and 80 patients, respectively. Serum homocysteine levels in the control, osteopenia, and osteoporosis groups were 15.01 ± 5.84, 15.42 ± 7.09, and 15.61 ± 7.88 mmol/L, respectively. There was no significant difference in Vitamin B12, Folate, Vitamin D, and TSH levels between the groups. After the confounding effects of age, gender, and body mass index were eliminated between the groups, a significant relationship was found between increased serum homocysteine levels and osteoporosis (OR:1.114; p <0.05). There was no statistically significant change in other results.

Conclusion: It has been determined that high serum homocysteine levels increase the risk of osteoporosis, which is a common and significant problem in older adults. Prospective studies are needed to support these results and clarify the reasons.

Keywords

Homocysteine, older adults, osteopenia, osteoporosis

References

• 1. Cosman F, Beur SJ de, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;5(10):2359–81.
• 2. Tuzun S, Eskiyurt N, Akarirmak U, et al. Incidence of hip fracture and prevalance of osteoporosis in Turkey: The FRACTURK Study. Osteoporos Int. 2012;23(3):949–55.
• 3. Christensen L, Iqbal S, Macarios D, et al. Cost of fractures commonly associated with osteoporosis in a managed-care population. J Med Econ. 2010;13(2):302–13.
• 4. Bliuc D, Niguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513–21.
• 5. Melton LJ, Achenbach SJ, Atkinson EJ, et al. Long-term mortality following fractures at different skeletal sites: A population-based cohort study. Osteoporos Int. 2013;24(5):1689–96.
• 6. Ontan MS, Dokuzlar O, Ates Bulut E, et al. The relationship between osteoporosis and sarcopenia, according to EWGSOP‑2 criteria, in outpatient elderly. J Bone Miner Metab. 2021. doi: 10.1007/s00774-021-01213-6.
• 7. Zhou Q, Zhu L, Zhang D, et al. Oxidative Stress-Related Biomarkers in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analyses. Dis Markers. 2016;2016:7067984.
• 8. Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int. 2017;28(10):2781–90.
• 9. Leboff MS, Narweker R, LaCroix A, et al. Homocysteine Levels and Risk of Hip Fracture in Postmenopausal Women. J Clin Endocrinol Metab. 2009;94(4):1207–13.
• 10. Salari P, Larijani B, Abdollahi M. Association of hyperhomocysteinemia with osteoporosis: a systematic review. Therapy. 2008;5(2):215–222.
• 11. van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, et al. Homocysteine Levels and the Risk of Osteoporotic Fracture. N Engl J Med. 2004;350(20):2033–41.
• 12. Bahtiri E, Islami H, Rexhepi S, et al. Relationship of homocysteine levels with lumbar spine and femur neck BMD in postmenopausal women. Acta Reumatol Port. 2015;40(4):355–62.
• 13. WHO Scientific Group on the Assessment of Osteoporosis At Primary Health. 2004;(May 2004):5-7. https://www.who.int/chp/topics/Osteoporosis.pdf, Erişim Tarihi: 10.04.2021
• 14. Zhu K, Beilby J, Dick IM, et al. The effects of homocysteine and MTHFR genotype on hip bone loss and fracture risk in elderly women. Osteoporos Int. 2009;20(7):1183–91.
• 15. Kim B-J, Koh J-M, Ahn SH, et al. High serum total homocysteine levels accelerate hip bone loss in healthy premenopausal women and men. Bone. 2013;52(1):56–62.
• 16. Bahtiri E, Islami H, Rexhepi S, et al. Relationship of homocysteine levels with lumbar spine and femur neck BMD in postmenopausal women. Acta Reumatol Port. 2015;40:355–62.
• 17. Alak ZS, Bulut EA, Dokuzlar O, et al. Long-term effects of vitamin D deficiency on gait and balance in the older adults. Clin Nutr. 2020;39(12):3756–62.