Cargando…

Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study

IMPORTANCE: Vitamin supplementation far exceeding recommended doses is popular in segments of the population. However, adverse effects can occur. In a previous secondary analysis of combined data from 2 double-blind randomized clinical trials (RCTs), an unexpected increased risk of hip fracture was...

Descripción completa

Detalles Bibliográficos
Autores principales: Meyer, Haakon E., Willett, Walter C., Fung, Teresa T., Holvik, Kristin, Feskanich, Diane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512300/
https://www.ncbi.nlm.nih.gov/pubmed/31074816
http://dx.doi.org/10.1001/jamanetworkopen.2019.3591
_version_ 1783417680779280384
author Meyer, Haakon E.
Willett, Walter C.
Fung, Teresa T.
Holvik, Kristin
Feskanich, Diane
author_facet Meyer, Haakon E.
Willett, Walter C.
Fung, Teresa T.
Holvik, Kristin
Feskanich, Diane
author_sort Meyer, Haakon E.
collection PubMed
description IMPORTANCE: Vitamin supplementation far exceeding recommended doses is popular in segments of the population. However, adverse effects can occur. In a previous secondary analysis of combined data from 2 double-blind randomized clinical trials (RCTs), an unexpected increased risk of hip fracture was found among those treated with high doses of vitamin B(6) in combination with vitamin B(12). OBJECTIVES: To study if high intakes of vitamins B(6) and B(12) from food and supplements were associated with a risk of hip fracture in the Nurses’ Health Study and to investigate whether combined high intakes of both vitamins conferred a particularly increased fracture risk. DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study, 75 864 postmenopausal women in the United States were followed up from June 1984 through May 2014. The dates of analysis were July 2016 to June 2018. Information on hip fracture and a wide range of potential confounders was collected at baseline and with biennial follow-up questionnaires. Extensive dietary information was collected approximately every 4 years with a semiquantitative food frequency questionnaire. Relative risks (RRs) were calculated by Cox proportional hazards regression, with cumulative average intakes of vitamins B(6) and B(12) as main exposures, adjusting for potential confounders. MAIN OUTCOME AND MEASURE: Hip fracture. RESULTS: During follow-up, 2304 of 75 864 women had a hip fracture. Among the women with hip fractures, the median (range) age at hip fracture was 75.8 (46.7-93.0) years and the mean (SD) body mass index (calculated as weight in kilograms divided by height in meters squared) was 24.3 (4.6). Median (interquartile range) cumulative average intakes of total vitamins B(6) and B(12) were 3.6 (4.8) mg/d and 12.1 (11.7) μg/d, respectively. Both vitamin B(6) (RR, 1.29; 95% CI, 1.04-1.59 for an intake of ≥35 vs <2 mg/d; P = .06 for linear trend) and vitamin B(12) (RR, 1.25; 95% CI, 0.98-1.58 for an intake of ≥30 vs <5 μg/d; P = .02 for linear trend) were associated with increased fracture risk. Risk was highest in women with a combined high intake of both vitamins (B(6) ≥35 mg/d and B(12) ≥20 μg/d), exhibiting an almost 50% increased risk of hip fracture (RR, 1.47; 95% CI, 1.15-1.89) compared with women with a low intake of both vitamins (B(6) <2 mg/d and B(12) <10 μg/d). CONCLUSIONS AND RELEVANCE: In this cohort study, a combined high intake of vitamins B(6) and B(12) was associated with an increased risk of hip fracture. The intakes were far higher than the recommended dietary allowances. These findings add to previous studies suggesting that vitamin supplements should be used cautiously because adverse effects can occur.
format Online
Article
Text
id pubmed-6512300
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher American Medical Association
record_format MEDLINE/PubMed
spelling pubmed-65123002019-05-28 Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study Meyer, Haakon E. Willett, Walter C. Fung, Teresa T. Holvik, Kristin Feskanich, Diane JAMA Netw Open Original Investigation IMPORTANCE: Vitamin supplementation far exceeding recommended doses is popular in segments of the population. However, adverse effects can occur. In a previous secondary analysis of combined data from 2 double-blind randomized clinical trials (RCTs), an unexpected increased risk of hip fracture was found among those treated with high doses of vitamin B(6) in combination with vitamin B(12). OBJECTIVES: To study if high intakes of vitamins B(6) and B(12) from food and supplements were associated with a risk of hip fracture in the Nurses’ Health Study and to investigate whether combined high intakes of both vitamins conferred a particularly increased fracture risk. DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study, 75 864 postmenopausal women in the United States were followed up from June 1984 through May 2014. The dates of analysis were July 2016 to June 2018. Information on hip fracture and a wide range of potential confounders was collected at baseline and with biennial follow-up questionnaires. Extensive dietary information was collected approximately every 4 years with a semiquantitative food frequency questionnaire. Relative risks (RRs) were calculated by Cox proportional hazards regression, with cumulative average intakes of vitamins B(6) and B(12) as main exposures, adjusting for potential confounders. MAIN OUTCOME AND MEASURE: Hip fracture. RESULTS: During follow-up, 2304 of 75 864 women had a hip fracture. Among the women with hip fractures, the median (range) age at hip fracture was 75.8 (46.7-93.0) years and the mean (SD) body mass index (calculated as weight in kilograms divided by height in meters squared) was 24.3 (4.6). Median (interquartile range) cumulative average intakes of total vitamins B(6) and B(12) were 3.6 (4.8) mg/d and 12.1 (11.7) μg/d, respectively. Both vitamin B(6) (RR, 1.29; 95% CI, 1.04-1.59 for an intake of ≥35 vs <2 mg/d; P = .06 for linear trend) and vitamin B(12) (RR, 1.25; 95% CI, 0.98-1.58 for an intake of ≥30 vs <5 μg/d; P = .02 for linear trend) were associated with increased fracture risk. Risk was highest in women with a combined high intake of both vitamins (B(6) ≥35 mg/d and B(12) ≥20 μg/d), exhibiting an almost 50% increased risk of hip fracture (RR, 1.47; 95% CI, 1.15-1.89) compared with women with a low intake of both vitamins (B(6) <2 mg/d and B(12) <10 μg/d). CONCLUSIONS AND RELEVANCE: In this cohort study, a combined high intake of vitamins B(6) and B(12) was associated with an increased risk of hip fracture. The intakes were far higher than the recommended dietary allowances. These findings add to previous studies suggesting that vitamin supplements should be used cautiously because adverse effects can occur. American Medical Association 2019-05-10 /pmc/articles/PMC6512300/ /pubmed/31074816 http://dx.doi.org/10.1001/jamanetworkopen.2019.3591 Text en Copyright 2019 Meyer HE et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Meyer, Haakon E.
Willett, Walter C.
Fung, Teresa T.
Holvik, Kristin
Feskanich, Diane
Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title_full Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title_fullStr Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title_full_unstemmed Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title_short Association of High Intakes of Vitamins B(6) and B(12) From Food and Supplements With Risk of Hip Fracture Among Postmenopausal Women in the Nurses’ Health Study
title_sort association of high intakes of vitamins b(6) and b(12) from food and supplements with risk of hip fracture among postmenopausal women in the nurses’ health study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512300/
https://www.ncbi.nlm.nih.gov/pubmed/31074816
http://dx.doi.org/10.1001/jamanetworkopen.2019.3591
work_keys_str_mv AT meyerhaakone associationofhighintakesofvitaminsb6andb12fromfoodandsupplementswithriskofhipfractureamongpostmenopausalwomeninthenurseshealthstudy
AT willettwalterc associationofhighintakesofvitaminsb6andb12fromfoodandsupplementswithriskofhipfractureamongpostmenopausalwomeninthenurseshealthstudy
AT fungteresat associationofhighintakesofvitaminsb6andb12fromfoodandsupplementswithriskofhipfractureamongpostmenopausalwomeninthenurseshealthstudy
AT holvikkristin associationofhighintakesofvitaminsb6andb12fromfoodandsupplementswithriskofhipfractureamongpostmenopausalwomeninthenurseshealthstudy
AT feskanichdiane associationofhighintakesofvitaminsb6andb12fromfoodandsupplementswithriskofhipfractureamongpostmenopausalwomeninthenurseshealthstudy