Written by Marcia J. Egles, MD. This study of 94 adults with normal serum calcium and vitamin D levels and who had hip surgery for osteoarthritis demonstrated that those who had slight bone structure abnormalities also had low folate and vitamin B6 levels.

A recent German clinical research study has reported that low serum folate (vitamin B-9) and vitamin B6 (pyridoxine) are each associated with abnormalities in human bone structure. Several previous clinical trials have reported B vitamin deficiencies to be associated with osteoporosis (1).

Osteoporosis is a disease affecting more than ten million older Americans. Those with osteoporosis, or “porous bone”, frequently suffer bone fractures. More than two million such fractures occur in the United States annually, at an estimated cost of 17 billion dollars (2).

The study examined bone obtained from 94 men and women who underwent hip surgery for osteoarthritis. The participants ranged in age from 52-83 years, with an average age of 70. Sixty-two percent were women and 9% were smokers. Only those with normal serum calcium and vitamin D were allowed into the study. Also excluded were those taking steroids and other drugs known to affect bone metabolism. The bone samples were subjected to tests of bone strength and hardness as well as examination of the microscopic architecture of the bone. The tests used included dual-energy xray absorptiometry which is a bone density test, indentation method biomechanical testing, and histiomorphometric analysis. These results were then compared to blood levels of B vitamins and other factors in the participants.

The study found that slight abnormalities of bone structure could be correlated to low serum levels of folate and vitamin B-6. The abnormalities were present in the cancellous or “spongy” bone component of bone, the part of bone most affected by osteoporosis. The trabeculae , the microscopic supportive struts of the spongy bone, were shown to be fewer in number (30 versus 37 trabculae per unit area, p-value equals 0.03) in those with low vitamin B-6. A lessened trabecular thickness (0.29 millimeters versus .035 millimeters, p-value equals 0.02) and less overall trabecular area (10.3 per cent versus 14.2 per cent, p value equals 0.02) was demonstrated in those with low serum folate. Tests of bone mineral density and biomechanical strength, however, did not show significant differences between those with high and low serum B vitamin levels.

This study was performed in patients with osteoarthritis of the hip severe enough to receive surgical intervention. Further studies would be required to determine whether bone properties are affected by B vitamin status in persons without osteoarthritis.

Source: Holstein, Joerg H., et al. “Low serum folate and vitamin B-6 are associated with an altered cancellous bone structure in humans.” The American journal of clinical nutrition 90.5 (2009): 1440-1445.

© 2009 American Society for Nutrition

Posted May 7, 2010.

References:

  1. Hermann M et al. The role of hyperhomocysteinemia as well as folate, vitamin B(6) and B(12) deficiencies in osteoporosis: a systemic review. Clin Chem Lab Med 2007: 45: 1621-32.
  2. Cummings SR et al. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002: 359: 1761-7.