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Folate and Vitamin B12 for Hip Fracture Prevention After Stroke—Reply
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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
We believe that hyperhomocysteinemia is related to bone quality through inhibition of collagen cross-linking. We previously found that serum osteocalcin was low in the convalescent stage of stroke4 and that vitamin K was low due to malnutrition in patients . . . [Full Text of this Article]
Yoshihiro Sato, MD
y-sato@ktarn.or.jp
Yoshiaki Honda, MD
Department of Neurology
Mitate Hospital
Tagawa
Jun Iwamoto, MD
Department of Sports Medicine
Keio University School of Medicine
Tokyo
Tomohiro Kanoko, PhD
Department of Rehabilitation Medicine
Kei Satoh, MD
Department of Vascular Biology
Hirosaki University School of Medicine
Hirosaki, Japan
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