Clin Osteol 2012; 17(2): 65-68

Serum homocysteine levels in children with fractures and low bone mineral density - a pilot studyOriginal contributions

Š. Kutílek, P. Řeháčková, V. Němec, E. Bočkayová

Background: High serum homocysteine (S-Hcy) levels are associated with low bone mineral density (BMD) and increased fracture risk in postmenopausal women. So far, data on S-Hcy and bone health are lacking in children and adolescents. Patients, Methods: We assessed S-Hcy levels in 19 children and adolescents (12 boys and 7 girls; mean age 14.9 ± 3.3 years) with pre­ valent low-energy trauma fractures (mean 4 ± 2.6 per patient) and/or low spinal L1-L4 BMD (below -2SD Z-score; DXA Lunar GE). Other assessments included serum alkaline phosphatase (S-ALP) and serum CrossLaps. At the time of assessment, the children were not taking any Z-scores ± SD.

Results: S-Hcy Z-score was significantly higher (1.4 ± 1.8; p = 0.001) and L1-L4 BMD Z-score was significantly lower (-2.1 ± 1.3; p = 0.0001), respectively, in comparison with reference values. S-ALP did not differ from reference values (p = 0.91), while S-CrossLaps were higher (1.5 ± 1.9; p = 0.001). S-Hcy was inversely correlated to L1-L4 BMD (r = -0.66; p = 0.01) and S-ALP (r = -0.56; p = 0.03) and not related to number of prevalent fractures (r = 0.11) or S-CrossLaps (r = -0.14). These results suggest negative influence of ele­ vated S-Hcy on bone formation and BMD in children with fractures, while bone resorption was increased in this group of pediatric pa­ tients. In conclusion, our results suggest that elevated S-Hcy is a risk facto Further studies are necessary for more detailed clarification of these issues.

Keywords: homocysteine, bone mineral density, fractures, bone turnover markers Address: Doc. MUDr. Štěpán Kutilek, CSc., Department of Pediatrics, Pardubi

Published: December 11, 2012  Show citation