Association of Methylenetetrahydrofolate Reductase rs1801133 Polymorphism with osteoporosis and fracture risk in Taiwan

Abstract

Introduction: Osteoporosis is a prevalent skeletal disorder influenced by age, hormonal changes, medication use, nutrition, and genetics. The relationship between MTHFR and osteoporosis remains unclear, especially in Asians. The aim of our study was to elucidate the impact of MTHFR on osteoporosis and fracture risk. Materials and Methods: Participants were recruited from the Taiwan Precision Medicine Initiative at Taichung Veterans General Hospital. A total of 3,503 subjects with available bone mineral density measurements were selected. Using the Axiom Genome-Wide TWB 2.0 Array, we identified the MTHFR rs1801133 variant. Among these subjects, 1,624 patients carrying the variant were included in the case group, while the remaining 1,879 patients without the variant served as the control group. Results: Overall, individuals carrying the MTHFR rs1801133 variant exhibited a significantly elevated risk of developing osteoporosis. Stratified analysis by different genotypes, the results revealed a statistically significant association between the heterozygous genotype of MTHFR rs1801133 and osteoporosis. However, there was no significant correlation between MTHFR genotypes and fracture risk. Furthermore, subgroup analysis of female patients revealed age, a known risk factor, was associated with both osteoporosis and fractures. Interestingly, the presence of the MTHFR rs1801133 variant did not confer an increased risk of osteoporosis or fractures in females. Conclusion: Our study revealed a notable increase in the prevalence of osteoporosis among individuals carrying the MTHFR rs1801133 variant. Nevertheless, these individuals did not exhibit a heightened risk of major or hip fractures compared to non-carriers. Our findings could be of value in raising awareness of the increased risk of osteoporosis among individuals with this genetic variant.

Keywords: MTHFR; MTHFR rs1801133; bone mineral density; fracture; osteoporosis.

Figure 1

The pathways of folate metabolism (left cycle) and methionine metabolism (right cycle), highlighting the role of the MTHFR gene and the cofactor vitamin B2. DHF, dihydrofolate; THF, tetrahydrofolate; 5,10-methylene THF, 5,10-methylene tetrahydrofolate; 5-Methyl THF, 5-methyl tetrahydrofolate. B2, cobalamin (vitamin B2); SAM, S-adenosyl-methionine; SAH, S-adenosyl-homocysteine.

Figure 2

Study participants enrollment flow chart. TPMI, Taiwan Precision Medicine Initiative; BMD, Bone Mineral Density; TCVGH, Taichung Veterans General Hospital; MTHFR, Methylenetetrahydrofolate Reductase.