High serum total homocysteine levels accelerate hip bone loss in healthy premenopausal women and men

► Serum tHcy level was significantly higher in men than women, and, among women, in postmenopausal women than premenopausal women. ► Higher serum tHcy concentrations were independently associated with accelerated hip bone loss in premenopausal women and men. ► In contrast, there was no relationship between serum tHcy levels and hip bone loss in postmenopausal women. ► First clinical evidence demonstrating that the detrimental effects of tHcy on bone loss are predominant in relatively younger subjects.