Horm Metab Res 2007; 39(8): 543-547
DOI: 10.1055/s-2007-985131
Original Basic

© Georg Thieme Verlag KG Stuttgart · New York

MTHFR C677T Polymorphism and Osteoporotic Fractures

C. Valero 1 , M. A. Alonso 2 , M. T. Zarrabeitia 3 , C. Viadero 4 , J. L. Hernández 1 , J. A. Riancho 1
  • 1Department of Internal Medicine, Hospital U. M. Valdecilla, University of Cantabria, Santander,Spain
  • 2Department of Traumatology, Hospital U. M. Valdecilla, University of Cantabria, Santander,Spain
  • 3Unit of Legal Medicine, University of Cantabria, Santander, Spain
  • 4Centro de Mayores Cueto, Santander, Spain
Weitere Informationen

Publikationsverlauf

received 18.12.2006

accepted 22.02.2007

Publikationsdatum:
21. August 2007 (online)

Abstract

The C677T (rs1801133) polymorphism of MTHFR (methylenetetrahydrofolate reductase) has been associated with the risk of cardiovascular events, and also with osteoporosis in some studies. However, the results are controversial. Our objective was to determine the relationship of the polymorphism with osteoporotic fractures by means of a case-control study. C677T was analyzed in 823 subjects (365 controls, 136 with vertebral fractures and 322 with hip fracture) by using a Taqman assay. The distribution of MTHFR genotypes was similar in patients and controls. In comparison with TC/CC genotypes, the age-adjusted OR for hip fractures of the TT genotype was 1.0 (95% confidence interval 0.6-1.7) in women and 0.7 (0.3-1.8) in men. The OR for vertebral fractures was 0.8 (0.4-1.7) in women and 1.7 (0.4-6.7) in men. A meta-analysis combining these data with previous reports confirmed the lack of association between MTHFR and fractures, with an OR of 1.1 (0.7-1.9, p=0.65) for vertebral fractures and 1.2 (0.7-2.0; p=0.45) for peripheral fractures, but there was significant heterogeneity among the results of individual studies, particularly about peripheral fractures. In conclusion, the C677T polymorphism of the MTHFR gene does not appear to be associated with the overall risk of osteoporotic fractures. However, given the heterogeneity of the results of published studies, further investigations are needed to evaluate its influence in specific population subgroups.

References

  • 1 Hamerman D. Osteoporosis and atherosclerosis: biological linkages and the emergence of dual-purpose therapies.  QJM. 2005;  98 467-484
  • 2 Jorgensen L, Joakimsen O, Rosvold Berntsen GK, Heuch I, Jacobsen BK. Low bone mineral density is related to echogenic carotid artery plaques: a population-based study.  Am J Epidemiol. 2004;  160 549-556
  • 3 Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis.  BMJ. 2002;  325 1202-1207
  • 4 MacLean RR, Jacques PF, Selhub J, Tucker KL, Samelson EJ, Broe KE. et al . Homocysteine as a predictive factor for hip fractures in older persons.  N Engl J Med. 2004;  350 2042-2049
  • 5 Meurs JBJ Van, Dhonukshe-Rutten RAM, Pluijm SMF, Klift M Van der, Jonge R de, Lindemans J. et al . Homocysteine levels and the risk of osteoporotic fracture.  N Engl J Med. 2004;  350 2033-2041
  • 6 Casas JP, Bautista LE, Smeeth L, Sharma P, Hingorani AD. Homocysteine and stroke: evidence on a causal link from mendelian randomisation.  Lancet. 2005;  365 224-232
  • 7 Miyao M, Morita H, Hosoi T, Kurihara H, Inoue S, Hoshimo S. et al . Association of methylenetetrahydrofolate reductase (MTHFR) polymorphism with bone mineral density in postmenopausal Japanese women.  Calcif Tissue Int. 2000;  66 190-194
  • 8 Villadsen MM, Bünger MH, Carstens M, Stenkjaer L, Langdahl BL. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is associated with osteoporotic vertebral fractures, but is a weak predictor of BMD.  Osteoporos Int. 2005;  16 411-416
  • 9 MacLean RR, Karasik D, Selhub J, Tucker KL, Ordovas J, Russo GT. et al . Association of a common polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene with bone phenotypes depends on plasma folate status.  J Bone Miner Res. 2004;  19 410-418
  • 10 MacDonald HM, MacGuigan FE, Fraser WD, New SA, Ralston SH, Reid DM. Methylenetetrahydrofolate reductase polymorphism interacts with riboflavin intake to influence bone mineral density.  Bone. 2004;  35 957-964
  • 11 Abrahamsen B, Jorgensen HL, Nielsen TL, Andersen M, Haug E, Schwarz P. et al . MTHFR c.677C>T polymorphism as an independent predictor of peak bone mass in Danish men-results from the Odense Androgen Study.  Bone. 2006;  38 215-219
  • 12 Abrahamsen B, Madsen JS, Tofteng CL, Stilgren L, Bladbjerg EM, Kristensen SR. et al . A common methylenetetrahydrofolate reductase (C677T) polymorphism is associated with low bone mineral density and increased fracture incidence after menopause:longitudinal data from the Danish osteoporosis prevention study.  J Bone Miner Res. 2003;  18 723-729
  • 13 Bathum L, Bornemann-Hjelmorbg J von, Christiansen L, Madsen JS, Skytthe A, Christensen K. Evidence for an association of methylene tetrahydrofolate reductase polymorphism C677T and an increased rsik of fractures: results from a population-based Danish study.  Osteoporos Int. 2004;  15 659-664
  • 14 Jorgensen HL, Madsen JS, Madsen B, Saleh MMA, Abrahamsen B, Fenger M. et al . Association of a common allelic polymorphism (C677T) in the methylene tetrahydrofolate reductase gene with a reduced risk of osteoporotic fractures. A case control study in Danish postmenopausal women.  Calcif Tissue Int. 2002;  71 386-392
  • 15 Li M, Lau EM, Woo J. Methylenetetrahydrofolate reductase polymorphism (MTHFR C677T) and bone mineral density in Chinese men and women.  Bone. 2004;  35 1369-1374
  • 16 Molloy AM, Daly S, Mills JL, Kirke PN, Whitehead AS, Ramsbottom D. et al . Thermolabile variant of 5,10-methylenetetrahydrofolate reductase associated with low red-cell folates: implications for folate intake recommendations.  Lancet. 1997;  349 1591-1593
  • 17 Ralston SH. Genetic control of susceptibility to osteoporosis.  J Clin Endocrinol Metab. 2002;  87 2460-2466
  • 18 Michaelsson K, Melhus H, Ferm H, Ahlbom A, Pedersen NL. Genetic liability to fractures in the elderly.  Arch Intern Med. 2005;  165 1825-1830
  • 19 Cagnacci A, Baldassari F, Rivolta G, Arangino S, Volpe A. Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women.  Bone. 2003;  33 956-959
  • 20 Dhonukshe-Rutten RAM, Pluijm SMF, Groot LCPM de, Lips P, Smit JH, Staveren WA van. Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people.  J Bone Miner Res. 2005;  20 921-929
  • 21 Gjesdal CG, Vollset SE, Ueland PM, Refsum H, Drevon CA, Gjessing HK. et al . Plasma total homocysteine level and bone mineral density: the Hordaland Homocysteine Study.  Arch Intern Med. 2006;  166 88-94
  • 22 Raisz LG. Homocysteine and osteoporotic fractures-culprit or bystander?.  N Engl J Med. 2004;  350 2089-2090
  • 23 Abrahamsen B, Madsen JS, Tofteng CL, Stilgren L, Bladbjerg EM, Kristensen SR. et al . Are effects of MTHFR (C677T) genotype on BMD confined to women with low folate and riboflavin intake? Analysis of food records from the Danish osteoporosis prevention study.  Bone. 2005;  36 577-583
  • 24 Powers HJ. Interaction among folate, riboflavin, genotype, and cancer, with reference to colorectal and cervical cancer.  J Nutr. 2005;  135 ((12 Suppl)) 2960S-2966S
  • 25 Ulrich CM. Nutrigenetics in cancer research - folate metabolism and colorectal cancer.  J Nutr. 2005;  135 2698-2702
  • 26 Balk EM, Raman G, Tatsioni A, Chung M, Lau J, Rosenberg IH. Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials.  Arch Intern Med. 2007;  167 21-30
  • 27 Bazzano LA, Reynolds K, Holder KN, He J. Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomized controlled trials.  JAMA. 2006;  296 2720-2726
  • 28 Green TJ, MacMahon JA, Skeaff CM, Williams SM, Whiting SJ. Lowering homocysteine with B vitamins has no effect on biomarkers of bone turnover in older persons: a 2-y randomized controlled trial.  Am J Clin Nutr. 2007;  85 460-464
  • 29 Hong X, Hsu YH, Terwedow H, Tang G, Liu X, Jiang S. et al . Association of the methylenetetrahydrofolate reductase C677T polymorphism and fracture risk in Chinese postmenopausal women.  Bone. 2007;  40 737-742

Correspondence

J. A. Riancho

Department of Internal Medicine

Hospital U. M. Valdecilla

39008 Santander

Spain

Telefon: +34/942/20 25 13

Fax: +34/942/20 16 95

eMail: rianchoj@unican.es