Homocysteine Levels and Osteoporotic Fracture in a Population Aged 55 Years Over in Medan District Indonesia


  • Sry Suryani Widjaja Department of Biochemistry, Universitas Sumatera Utara, Medan, Indonesia
  • Rusdiana Rusdiana Department of Biochemistry, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-7308-9291
  • Vito Filbert Jayalie Department of Radiation Oncology, Universitas Indonesia, Jakarta, Indonesia image/svg+xml




Osteoporosis, Fracture, Homocysteine, Bone density


BACKGROUND: Osteoporosis is a chronic, progressive, systemic, skeletal, multifactorial disorder characterized by low bone mass, microarchitectural deterioration of bone tissues that increased the risk of fragility fracture. The increased prevalence of early osteoporosis in homocystinuria illustrates that homocysteine metabolism is involved in the process of osteoporosis.

AIM: This study was aimed to look for the relationship between homocysteine levels in the blood and the occurrence of osteoporotic fractures in the population above 55 years old.

METHODS: This is a descriptive study with cross-sectional approach, total sixty-five patients aged 55 years or older with osteoporotic fracture and as a control group without osteoporotic fracture. Blood pressure, heart rate, and body weight were recorded, bone density was measured using central dual-energy x-ray absorptiometry (DXA) machine/DXA and homocysteine plasma levels were measured using the enzyme-linked immunoassay method.

RESULTS: Total of 65 samples with age range between 55 and 88 years, they were 38 peoples with osteoporosis, which 12 got the osteoporotic fracture. Among the 16 samples in osteopenia group, two got the fracture, among 11 samples with normal bone density, one got the osteoporotic fracture. There was statistical significant between fracture and bone mineral density (p = 0.00) and no statistical significant between bone density and gender (p = 0.08), bone density and body mass index (BMI) (p = 0.11). There was statistical significant correlation between homocysteine and age (p = 0.02), age and bone density (p = 0.002) but no statistical significant correlation between homocysteine and BMI (p = 0.07), homocysteine and osteoporotic fracture (p = 0.87).

CONCLUSIONS: Homocysteine level did not increased the incidence of osteoporotic fracture, however homocysteine increased with aging and correlated with bone mineral density.


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World Health Organization. Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis. Report of a WHO Study Group. Geneva: World Health Organization; 1994.

Van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R, Lindemans J, et al. Homocysteine levels and the risk of osteoporotic fracture. N Eng J Med. 2004;350(20):2033-41. https://doi.org/10.1056/NEJMoa032546 PMid:15141041 DOI: https://doi.org/10.1056/NEJMoa032546

Van Wijngaarden JP, Doets EL, Szczecińska A, Souverein OW, Duffy ME, Dullemeijer C, et al. Vitamin B12, folate, homocysteine, and bone health in adults and elderly people: A systematic review with meta-analyses. Nutr Metable. 2013;2013:486186. https://doi.org/10.1155/2013/486186 PMid:23509616 DOI: https://doi.org/10.1155/2013/486186

Górski R, Chmielewski D, Zgoda M. The evaluation of social awareness of osteoporosis: Based on the aimed questionnaire. Ortop Traumatol Rehabil. 2006;8(6):627-32. PMid:17581512

Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, et al. Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int. 2000;11(8):669-74. https://doi.org/10.1007/s001980070064 PMid:11095169 DOI: https://doi.org/10.1007/s001980070064

Devlin M. Thomas,editor. Text book of biochemistry with clinical correlations.5 ed. Wiley-Liss Publication;2002.803-6.

Mudd SH, Skooby F, Levy H, Pettigrew KD, Wilcken B, Pyeritz RE, et al. The natural history of homocysteinedue to cystathionine beta-synthase deficiency. Am J Hum Genet. 1985;37(1):1-31. PMid:3872065

Herrmann M, Schmidt JP, Umanskaya N, Wagner A, Taban-Shomal O, Widmann T, et al. The role of hyperhomocysteinemia as well as folate, Vitamin B6 and B12 deficiencies in osteoporosis: A systematic review. Choose Destination Clin Chem Lab Med. 2007;45(12):1621-32. https://doi.org/10.1515/CCLM.2007.362 PMid:18067447 DOI: https://doi.org/10.1515/CCLM.2007.362

Welch GN, Loscalzo J. Homocysteine and atherothrombosis. New Eng J Med. 1998;338(15):1042-50. https://doi.org/10.1056/NEJM199804093381507 PMid:9535670 DOI: https://doi.org/10.1056/NEJM199804093381507

Koh JM, Lee YS, Kim YS, Kim DJ, Kim HH, Park JY, et al. Homocysteine enhances bone resorption by stimulation of osteoclast formation and activity through increased intracellular ROS generation. J Bone Miner Res. 2006;21(7):1003-11. https://doi.org/10.1359/jbmr.060406 PMid:16813521 DOI: https://doi.org/10.1359/jbmr.060406

Thaler R, Agsten M, Spitzer S, Paschalis EP, Karlic H, Klaushofer K, et al. Homocysteine suppresses the expression of the collagen cross-linker lysyl oxidase involving IL-6, Fli1, and epigenetic DNA methylation. J Biol Chem. 2011;286(7):5578-88. https://doi.org/10.1074/jbc.M110.166181 PMid:21148317 DOI: https://doi.org/10.1074/jbc.M110.166181

Lubec B, Fang KS, Lubec T, Blom HJ, Boers GH. Evidence for McKusick’s hypothesis of deficient collagen cross-linking in patients with homocysteinuria. Biochem Biophys Acta. 1996;1315(3):159-62. https://doi.org/10.1016/0925-4439(95)00119-0 PMid:8611653 DOI: https://doi.org/10.1016/0925-4439(95)00119-0

Mc Lean RR, Jacques PF. Homocysteine as a predictive factor for hip fracture in older persons. N Eng J Med. 2004;350(20):2042-9. https://doi.org/10.1056/NEJMoa032739 PMid:15141042 DOI: https://doi.org/10.1056/NEJMoa032739

Herrmann M, Umanskaya N, Wildemann B, Colaianni G, Widmann T, Zallone A, et al. Stimulation of osteoblast activity by homocysteine. J Cell Mol Med. 2008;12(4):1205-10. https://doi.org/10.1111/j.1582-4934.2008.00104.x PMid:18782184 DOI: https://doi.org/10.1111/j.1582-4934.2008.00104.x

Shiraki M, Kuroda T, Shiraki Y, Tanaka S, Higuchi T, Saito M. Urinary pentosidine and plasma homocysteine levels at baseline predict future fractures in osteoporosis patients under bisphosphonate treatment. J Bone Miner Metab. 2011;29(1):62- 70. https://doi.org/10.1007/s00774-010-0191-2 PMid:20458602 DOI: https://doi.org/10.1007/s00774-010-0191-2

Bahtiri E, Islami I, Rexhepi S, Qorraj-Bytyqi H, Thaçi K, Thaçi S, et al. Relationship of homocysteine levels with lumbar spine and femur neck BMD in postmenopausal women. Acta Rheumatol Port. 2015;40(4):355-62. PMid:26922199

Kim JI, Moon JH, Chung HW, Kong MH, Kim HJ. Association between homocysteine and bone mineral density according to age and sex in healthy adults. J Bone Metab. 2016;2(3):129-34. https://doi.org/10.11005/jbm.2016.23.3.129 PMid:27622176 DOI: https://doi.org/10.11005/jbm.2016.23.3.129

Tariq S, Lone KP, Tariq S. Comparison of parameters of bone profile and homocysteine in physically active and non-active postmenopausal females. Pak J Med Sci. 2016;32(5):1263-7. https://doi.org/10.12669/pjms.325.10655 PMid:27882033 DOI: https://doi.org/10.12669/pjms.325.10655

Heaney RP. Dairy and bone health. J Am Coll Nutr. 2009;28(Suppl 1):82-90. https://doi.org/10.1080/07315724.2009.10719808 PMid:19571166 DOI: https://doi.org/10.1080/07315724.2009.10719808




How to Cite

Widjaja SS, Rusdiana R, Jayalie VF. Homocysteine Levels and Osteoporotic Fracture in a Population Aged 55 Years Over in Medan District Indonesia. Open Access Maced J Med Sci [Internet]. 2022 Jan. 8 [cited 2023 Mar. 22];10(A):45-8. Available from: https://oamjms.eu/index.php/mjms/article/view/7901

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