Low plasma vitamin B12 is associated with lower BMD: the Framingham Osteoporosis Study

J Bone Miner Res. 2005 Jan;20(1):152-8. doi: 10.1359/JBMR.041018. Epub 2004 Oct 25.


Vitamin B12 is important to DNA synthesis and may affect bone formation. We examined the association between this vitamin and BMD in 2576 adults. Men with plasma B12 < 148 pM had significantly lower BMD at the hip, and women at the spine, relative to those with higher B12, and trends were similar for both at all sites. Low vitamin B12 may be a risk factor for low BMD.

Introduction: Vitamin B12 is important to DNA synthesis and may affect bone formation. It has been linked to osteoblastic activity in clinical studies and cell culture.

Materials and methods: We examined the relationship between plasma vitamin B12 status and BMD in 2576 adult participants in the Framingham Offspring Osteoporosis Study (1996-2001). BMD was measured by DXA at the hip and spine. Plasma vitamin B12 was measured by radioassay. Mean BMD measures were estimated for four categories of vitamin B12 concentration, based on commonly used cut-offs, using analysis of covariance, adjusted for age, BMI, physical activity score for the elderly (PASE), alcohol use, smoking status, total calcium and vitamin D intake, season of bone measurement, and for women, menopause status and current estrogen use. Further adjustment for protein intake and total homocysteine concentration was also performed.

Results: Both men and women with vitamin B12 concentrations <148 pM had lower average BMD than those with vitamin B12 above this cut-off. These differences were significant (p < 0.05) for men at most hip sites and for women at the spine. Significance remained after further adjustment for protein intake and plasma homocysteine.

Conclusions: Vitamin B12 deficiency may be an important modifiable risk factor for osteoporosis.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Bone Density*
  • Cohort Studies
  • Female
  • Hip
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / etiology*
  • Osteoporosis / metabolism
  • Spine / chemistry
  • Spine / metabolism
  • Vitamin B 12 / blood*
  • Vitamin B 12 Deficiency / complications*
  • Vitamin B 12 Deficiency / metabolism


  • Vitamin B 12