ArticleAnnals of translational medicine2021
The association of homocysteine, folate, vitamin B12, and vitamin B6 with fracture incidence in older adults: a systematic review and meta-analysis.
Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- B vitamins and bone health: a meta-analysis with trial sequential analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Folate and global health review series, part 4: syntheses on folate and autoimmune diseases and skeletal outcomes.Journal of global health · 2026Review
- Article
- Inherited disorders of cobalamin metabolism in childhood: biochemical and clinical perspectives.Frontiers in nutrition · 2026Review
- Roles of gut metabolites on bone mineralization and remodeling: impact of metabolic dysregulation on the gut-immune-bone axis.Frontiers in endocrinology · 2026Review
- Hyperhomocysteinemia in pediatric β-thalassemia: links to vitamin cofactor deficiencies and oxidative stress.Clinical and experimental pediatrics · 2025Article
- Article
- Role of vitamins beyond vitamin DInternational journal of molecular medicine · 2024Review
- Serum 5-Methyltetrahydrofolate Status Is Associated with One-Carbon Metabolism-Related Metabolite Concentrations and Enzyme Activity Indicators in Young Women.International journal of molecular sciences · 2023Article
- Establishment and Verification of a Predictive Nomogram for New Vertebral Compression Fracture Occurring after Bone Cement Injection in Middle-Aged and Elderly Patients with Vertebral Compression Fracture.Orthopaedic surgery · 2023Article
- Homocysteine, Vitamin B12 and Folate Level: Possible Risk Factors in the Progression of Chronic Heart and Kidney Disorders.Current cardiology reviews · 2023Article
- Association of pentosidine and homocysteine levels with number of teeth present in Japanese postmenopausal women.Journal of bone and mineral metabolism · 2022Article
- Pleural homocysteine for malignant pleural effusion: A prospective and double-blind diagnostic test accuracy study.Thoracic cancer · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiverse conclusions have been drawn regarding the association of homocysteine (HCY) deficiency and supplements of B vitamins with fracture incidence in older adults. The aim of this meta-analysis was to investigate the association of HCY and B vitamins (folate, vitamin B12, and B6) with fracture incidence in older adults and whether supplements of B vitamins reduce the risk of fracture.
methodsThe PubMed, Embase, and Cochrane library databases were systematically searched from their inception dates to 1 July 2019 to identify relevant published articles. Meta-analysis was performed to pool hazard ratios (HRs) or risk ratios (RRs) and 95% confidence intervals (CIs) using a random effects model.
resultsA total of 28 studies fulfilled the inclusion criteria. High serum HCY was an independent risk factor for fractures in older persons (HR =1.25, 95% CI: 1.12 to 1.40), but only at the highest quartile level (>15 µmol/L) (HR =1.71, 95% CI: 1.37 to 2.12), rather than the second and third quartile. Multiple sensitivity and subgroup analyses supported the consistency and stability of this result. A severe deficiency of folate, instead of vitamin B12 and B6, was found to increase the risk of fracture in older adults (HR =1.46, 95% CI: 1.06 to 2.02; 1.24, 95% CI: 0.79 to 1.95; 1.36, 95% CI: 0.90 to 2.06, respectively). For the interventional effect, there was no significant association of combined folate and vitamin B12, combined folate, vitamin B12 and B6, or single vitamin B6 supplementation with the decrease of fracture risk. DISCUSSION: This meta-analysis revealed that significantly elevated serum level of HCY is positively associated with fracture incidence in older adults, yet the necessity and threshold for intervention by B vitamins require further large-scale high-quality clinical trials to validate. PROSPERO IDENTIFIER: CRD42019122586.
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