This population-based study examined cobalamin status and incident fractures in elderly men (n = 790) with an average follow-up of 5.9 years. This study aimed to determine whether serum cobalamins or holotranscobalamin (holoTC: the metabolic active cobalamin) predict incident fractures. Men participating in the Gothenburg part of the population-based Osteoporotic Fracturs in Men (MrOS) Sweden cohort and without ongoing vitamin B medication were included in the study (age range 70- 81 years). The results showed that 110 men sustained X-ray verified fractures including 45 men with clinical vertebral fractures. The risk of fracture (adjusted for age, smoking, BMI, BMD, falls, prevalent fracture, tHcy, cystatin C, 25-OH-vitamin D, intake of calcium, and physical activity, increased per each standard deviation decrease in cobalamins (HR 1.38; 95 % CI, 1.11-1.72) and holoTC (HR, 1.26; 95 % CI, 1.03-1.54), respectively. Men in the lowest quartile of cobalamins and holoTC had an increased risk of all fracture (cobalamins, HR = 1.67 (95 % CI, 1.06-2.62); holoTC, HR = 1.74 (95 % CI, 1.12-2.69)). No associations between folate or tHcy and incident fractures were seen. The authors conclude that low levels of holoTC and cobalamins predict incident fracture in elderly men. Osteoporos Int, October 2013. PMID: 24129588
