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August 17, 2005

Folate and Vitamin B

JAMA. 2005;294(7):792. doi:10.1001/jama.294.7.792-b

In Reply: Because folate and vitamins B12 and B6 are major determinants of serum homocysteine concentration in older persons,1 inadequate amounts of 1 or more vitamins might be responsible for our observed effect on the risk of hip fracture. A recent population-based study2 showed that older women with low BMD had significantly lower vitamin B12 concentrations than those with higher BMD; however, this was not found in men. In addition, missense mutations of the gene for methylenetetrahydrofolate reductase may cause homocystinuria.3 A polymorphism of methylenetetrahydrofolate reductase, in which a substitution of valine for alanine results in decreased enzyme activity, is associated with higher than normal homocysteine levels and with decreased BMD.3