{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:58:10Z","timestamp":1787507890354,"version":"build-2736575974"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2005,3,2]]},"abstract":"\n Context<\/jats:title>\n \n Stroke increases the risk of subsequent hip fracture by 2 to 4 times.\n Hyperhomocysteinemia is a risk factor for both ischemic stroke and\n osteoporotic fractures in elderly men and women. Treatment with folate and\n mecobalamin (vitamin B\n 12<\/jats:sub>\n ) may improve hyperhomocysteinemia.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To investigate whether treatment with folate and vitamin B\n 12<\/jats:sub>\n reduces the incidence of hip fractures in patients with hemiplegia following\n stroke.\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Patients<\/jats:title>\n A double-blind, randomized controlled study of 628 consecutive patients aged\n 65 years or older with residual hemiplegia at least 1 year following first\n ischemic stroke, who were recruited from a single Japanese hospital from\n April 1, 2000, to May 31, 2001. Patients were assigned to daily oral\n treatment with 5 mg of folate and 1500 \u03bcg of mecobalamin, or double\n placebo; 559 completed the 2-year follow-up.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure<\/jats:title>\n Incidence of hip fractures in the 2 patient groups during the 2-year\n follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At baseline, patients in both groups had high levels of plasma homocysteine\n and low levels of serum cobalamin and serum folate. After 2 years, plasma\n homocysteine levels decreased by 38% in the treatment group and increased by\n 31% in the placebo group (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). The\n number of hip fractures per 1000 patient-years was 10 and 43 for the\n treatment and placebo groups, respectively\n (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). The adjusted relative risk,\n absolute risk reduction, and the number needed to treat for hip fractures in\n the treatment vs placebo groups were 0.20 (95% confidence interval [CI],\n 0.08-0.50), 7.1% (95% CI, 3.6%-10.8%), and 14 (95% CI, 9-28), respectively.\n No significant adverse effects were reported.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n In this Japanese population with a high baseline fracture risk, combined\n treatment with folate and vitamin B\n 12<\/jats:sub>\n is safe and effective in\n reducing the risk of a hip fracture in elderly patients following\n stroke.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.293.9.1082","type":"journal-article","created":{"date-parts":[[2005,3,1]],"date-time":"2005-03-01T16:23:34Z","timestamp":1109694214000},"page":"1082","source":"Crossref","is-referenced-by-count":225,"title":["RETRACTED: Effect of Folate and Mecobalamin on Hip Fractures in Patients With\n 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