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Effect of B vitamin (folate, B6, and B12) supplementation on osteoporotic fracture and bone turnover markers: a meta-analysis.

Ruan J, Gong X, Kong J, Wang H, Zheng X, Chen T - Med. Sci. Monit. (2015)

Bottom Line: Based on the results of 4 RCTs, this meta-analysis failed to identify a risk-reducing effect of daily supplementation of B vitamins on osteoporotic fracture in patients with vascular disease and with relatively normal plasma Hcy.In addition, we also did not find any positive effects of B vitamin supplementation on bone turnover.However, the possible benefits in selective populations, such as populations with very high plasma Hcy and from regions without B vitamin fortification should be explored in the future.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Taizhou Municpal Hospital, Taizhou, Zhejiang, China (mainland).

ABSTRACT

Background: B vitamins (including folate, B6, and B12) supplementation can effectively and easily modify high plasma homocysteine (Hcy). However, the role of Hcy in the pathogenesis of osteoporotic fracture and bone turnover is still controversial. This meta-analysis aimed to assess the impact of B vitamin supplementation on occurrence of any osteoporotic fracture and bone turnover by pooling the results of previous studies.

Material and methods: Relevant randomized controlled trials (RCTs) were searched in databases. Data integration and analysis were done by using Review Manager 5.3 (the Cochrane Collaboration). The risk ratio (RR) and corresponding 95% confidence intervals (CI) of fracture (intervention vs. control) were estimated. Changes in bone turnover indicators (continuous data), weighted mean difference (WMD), and corresponding 95% (CI) were pooled for estimation.

Results: Based on the results of 4 RCTs, this meta-analysis failed to identify a risk-reducing effect of daily supplementation of B vitamins on osteoporotic fracture in patients with vascular disease and with relatively normal plasma Hcy. In addition, we also did not find any positive effects of B vitamin supplementation on bone turnover.

Conclusions: B vitamin supplementation might not be effective in preventing fracture and improving bone turnover. However, the possible benefits in selective populations, such as populations with very high plasma Hcy and from regions without B vitamin fortification should be explored in the future.

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Meta-analysis of the effect of B vitamin supplementation on bone turnover. (A) Bone formation marker (ALP). (B) Resorption markers (CTX).
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f4-medscimonit-21-875: Meta-analysis of the effect of B vitamin supplementation on bone turnover. (A) Bone formation marker (ALP). (B) Resorption markers (CTX).

Mentions: Four RCTs with 329 participants assessed the change of bone formation markers after B vitamin supplementation [13,14,19,20]. One study [13] gave patients folate, B6, and B12 simultaneously, 1 study [19] used both folate and VB12, 1 study [14] provided VB6 and VB12, and 1 study [20] only provided folate. Although the combination of B vitamins varied in different studies, all of them reported that the intervention significantly reduced plasma Hcy. Bone formation marker (ALP) and resorption markers (CTX) were used to assess the effect of B vitamin supplementation on bone turnover. Generally, compared with placebo, supplementation of B vitamins had no significant effect on ALP (WMD: −0.96, 95%CI: −4.10 to 2.18, p=0.55, I2=0%) (Figure 4A) and CTX (WMD: −0.01, 95%CI: −0.06 to 0.07, p=0.87, I2=0%) (Figure 4B). Salari et al. [20] study measured urine CTX instead of serum CTX and their results also showed that folate supplementation could not change urine CTX (supplementation vs. placebo, p=0.285).


Effect of B vitamin (folate, B6, and B12) supplementation on osteoporotic fracture and bone turnover markers: a meta-analysis.

Ruan J, Gong X, Kong J, Wang H, Zheng X, Chen T - Med. Sci. Monit. (2015)

Meta-analysis of the effect of B vitamin supplementation on bone turnover. (A) Bone formation marker (ALP). (B) Resorption markers (CTX).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4384513&req=5

f4-medscimonit-21-875: Meta-analysis of the effect of B vitamin supplementation on bone turnover. (A) Bone formation marker (ALP). (B) Resorption markers (CTX).
Mentions: Four RCTs with 329 participants assessed the change of bone formation markers after B vitamin supplementation [13,14,19,20]. One study [13] gave patients folate, B6, and B12 simultaneously, 1 study [19] used both folate and VB12, 1 study [14] provided VB6 and VB12, and 1 study [20] only provided folate. Although the combination of B vitamins varied in different studies, all of them reported that the intervention significantly reduced plasma Hcy. Bone formation marker (ALP) and resorption markers (CTX) were used to assess the effect of B vitamin supplementation on bone turnover. Generally, compared with placebo, supplementation of B vitamins had no significant effect on ALP (WMD: −0.96, 95%CI: −4.10 to 2.18, p=0.55, I2=0%) (Figure 4A) and CTX (WMD: −0.01, 95%CI: −0.06 to 0.07, p=0.87, I2=0%) (Figure 4B). Salari et al. [20] study measured urine CTX instead of serum CTX and their results also showed that folate supplementation could not change urine CTX (supplementation vs. placebo, p=0.285).

Bottom Line: Based on the results of 4 RCTs, this meta-analysis failed to identify a risk-reducing effect of daily supplementation of B vitamins on osteoporotic fracture in patients with vascular disease and with relatively normal plasma Hcy.In addition, we also did not find any positive effects of B vitamin supplementation on bone turnover.However, the possible benefits in selective populations, such as populations with very high plasma Hcy and from regions without B vitamin fortification should be explored in the future.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Taizhou Municpal Hospital, Taizhou, Zhejiang, China (mainland).

ABSTRACT

Background: B vitamins (including folate, B6, and B12) supplementation can effectively and easily modify high plasma homocysteine (Hcy). However, the role of Hcy in the pathogenesis of osteoporotic fracture and bone turnover is still controversial. This meta-analysis aimed to assess the impact of B vitamin supplementation on occurrence of any osteoporotic fracture and bone turnover by pooling the results of previous studies.

Material and methods: Relevant randomized controlled trials (RCTs) were searched in databases. Data integration and analysis were done by using Review Manager 5.3 (the Cochrane Collaboration). The risk ratio (RR) and corresponding 95% confidence intervals (CI) of fracture (intervention vs. control) were estimated. Changes in bone turnover indicators (continuous data), weighted mean difference (WMD), and corresponding 95% (CI) were pooled for estimation.

Results: Based on the results of 4 RCTs, this meta-analysis failed to identify a risk-reducing effect of daily supplementation of B vitamins on osteoporotic fracture in patients with vascular disease and with relatively normal plasma Hcy. In addition, we also did not find any positive effects of B vitamin supplementation on bone turnover.

Conclusions: B vitamin supplementation might not be effective in preventing fracture and improving bone turnover. However, the possible benefits in selective populations, such as populations with very high plasma Hcy and from regions without B vitamin fortification should be explored in the future.

Show MeSH
Related in: MedlinePlus