Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women

Genetic hyperhomocysteinemia is associated with skeletal abnormalities and osteoporosis. We tested whether levels of homocysteine and critical co-enzymes of homocysteine metabolism, such as vitamin B₁₂ and folate, are related to lumbar spine bone mineral density (BMD) measured by DEXA in 161 postmenopausal women. Folate but not homocysteine or vitamin B₁₂, was lower in osteoporotic than normal women (7.2 ± 0.9 ng/L vs 11.4 ± 0.7 ng/L, P < 0.003). Folate, but not homocysteine or vitamin B₁₂, was independently related to BMD (r = 0.254, P < 0.011). BMD progressively increased from the lowest to the highest folate quartile (1.025 ± 0.03 g/cm² vs 1.15 ± 0.03 g/cm², P < 0.01) even when covaried for weight, which was the only other variable related to BMD. The present data suggest a major association between folate and bone mineralization.