Low vitamin B12 linked to fracture risk: Study

A low blood level of vitamin B12 may be linked to an increased risk of fractures in older men, according to new research.

The extensive new study, published in Osteoporosis International, forms part of an international research project initiated by the National Institutes of Health (NIH) in the US and comprises 11,000 men in total.

In their part of the study, the Swedish research team studied 1,000 men with an average age of 75, and used various methods to analyse the blood concentrations of the B vitamins B12 and folate - which are found in our food naturally.

Led by Catharina Lewerin from the University of Gothenburg, the study reports that the risk of suffering a fracture six years later was higher among men who had low B12 levels at the beginning of the study than men with normal B12 levels.

"We present novel data showing that low levels of holoTC [holotranscobalamin - the metabolic active cobalamin] and cobalamins predicting incident fracture in elderly men," reported Lewerin and her colleagues.

The team revealed that in the bottom quarter of men (with the lowest B12 content) risk was elevated by approximately 70% compared with the others. This risk increased especially in fractures of lumbar region, where the risk increase was up to 120%.

"The higher risk also remains when we take other risk factors for fractures into consideration, such as age, smoking, BMI, BMD (bone mineral density), previous fractures, physical activity, the D-vitamin content in the blood and calcium intake," said Lewerin.

Does this mean that older men can prevent fractures through increasing B12?

"It has not been scientifically established, but such studies are under way, including one large Dutch study where older individuals over the age of 65 are treated with both vitamin B12, folic acid and vitamin D to investigate the occurrence of fractures," Lewerin added.

"Right now, there is no reason to eat more vitamin B12, but rather treatment shall only be applied in confirmed cases of deficiencies and in some cases to prevent deficiencies," she said.  

Study details

The team used a relatively new method known as holotranscobalamin, which measures the amount of vitamin that is taken up in the cells, and is considered to be a more sensitive test for B12 deficiency.

During the follow period 110 men sustained X-ray-verified fractures including 45 men with clinical vertebral fracture, the team reported.

Risk of fracture was found to be increased for every standard deviation decrease in cobalamins and holoTC respectively.

Men in the lowest quartile of cobalamins and holoTC had an increased risk of all fracture compared with other quartiles. However no associations were reported between folate or tHcy and incident fractures.

Source: Osteoporosis International

Published online ahead of print - Study found here

"Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden"

Authors: C. Lewerin, H. Nilsson-Ehle, et al