A Quantitative Assessment of Plasma Homocysteine as a Risk Factor for Vascular Disease

Boushey, Carol J.; Beresford, Shirley A.A.; Omenn, Gilbert S.; Motulsky, Arno G.

doi:10.1001/jama.1995.03530130055028

Cited by 2,722 publications

(662 citation statements)

References 87 publications

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“…It is well established that plasma homocysteine levels can be reduced by pharmacological doses (5 mg) of supplemental folic acid (Boushey et al, 1995). Recent intervention studies have shown that a similar reduction in plasma tHcy can be accomplished by far smaller supplements, 500 mg (den Heijer et al, 1998;Brouwer et al, 1999a, b).…”

Section: Discussionmentioning

confidence: 99%

Folate intake, plasma folate and homocysteine status in a random Finnish population

Alfthan

Laurinen²,

Valsta³

et al. 2003

Eur J Clin Nutr

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Objective: To assess the folate status of Finnish adults using plasma folate and homocysteine as biomarkers and to evaluate dietary and supplementary folate intakes. Materials and methods: Plasma folate, vitamin B 12 and total homocysteine (tHcy) were determined in a random sample of 643 subjects aged 25 -74 y living in the Helsinki area. The methylenetetrahydrofolate reductase (MTHFR)-genotypes were analyzed from a subsample (n ¼ 394). Dietary intake data by 24 h recall and use of vitamin supplements were collected. Results: Plasma folate was normal ( ! 5 nmol=l) in 99% of subjects and optimal ( ! 8 nmol=l) in terms of a minimum tHcy in 90%. Mean plasma folate of non-supplement users was 13.7 and 12.9 nmol=l and tHcy 11.3 and 9.2 mmol=l for men and women, respectively. Elevated tHcy ( > 14 mmol=l) was found in 11% of subjects. Homozygote frequency for MTHFR genotype TT was 5.0% and their plasma tHcy was 14.8 mmol=l compared to the mean of the other subjects, 10.5 mmol=l, P < 0.05. The mean dietary folate intake was 241 mg=day (29 mg=MJ of energy) for men and 205 mg=day (33 mg=MJ) for women, respectively. The main dietary sources of folate were vegetables 12%, wholemeal ryebread 11%, fruits 10%, and potato 10%. Regular supplement users (n ¼ 97) received on average 207 mg folic acid per day from supplements. Conclusions: The folate status of Finnish adults seems to be adequate according to energy adjusted folate intake, plasma folate and homocysteine. The MTHFR homozygote frequency was low compared to other countries. Regular use of supplementary folic acid less than 300 mg increased plasma folate, but supplemental folic acid over 300 mg was required to lower tHcy values significantly.

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Section: Discussionmentioning

confidence: 99%

Folate intake, plasma folate and homocysteine status in a random Finnish population

Alfthan

Laurinen²,

Valsta³

et al. 2003

Eur J Clin Nutr

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“…Previous studies on homocysteine and homocysteine-related diseases reported linear doseeffects relations. [24][25][26] In line with these findings, we calculated the OR for a 5 mmol/l increase in homocysteine level, a standard reference increment. To estimate the log OR for a 5 mmol/l increase in homocysteine, information about the normal distribution was used to calculate the expected mean level of homocysteine in the groups being compared.…”

Section: Data Extraction and Synthesismentioning

confidence: 99%

Homocysteine, methylenetetrahydrofolate reductase and risk of schizophrenia: a meta-analysis

Muntjewerff¹,

et al. 2005

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Elevated plasma homocysteine concentration has been suggested as a risk factor for schizophrenia, but the results of epidemiological studies have been inconsistent. The most extensively studied genetic variant in the homocysteine metabolism is the 677C4T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene, resulting in reduced enzyme activity and, subsequently, in elevated homocysteine. A meta-analysis of eight retrospective studies (812 cases and 2113 control subjects) was carried out to examine the association between homocysteine and schizophrenia. In addition, a meta-analysis of 10 studies (2265 cases and 2721 control subjects) on the homozygous (TT) genotype of the MTHFR 677C4T polymorphism was carried out to assess if this association is causal. A 5 lmol/l higher homocysteine level was associated with a 70% (95% confidence interval, CI: 27-129) higher risk of schizophrenia. The TT genotype was associated with a 36% (95% CI: 7-72) higher risk of schizophrenia compared to the CC genotype. The performed meta-analyses showed no evidence of publication bias or excessive influence attributable to any given study. In conclusion, our study provides evidence for an association of homocysteine with schizophrenia. The elevated risk of schizophrenia associated with the homozygous genotype of the MTHFR 677C4T polymorphism provides support for causality between a disturbed homocysteine metabolism and risk of schizophrenia.

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“…12-14 A 5 mmol/l plasma homocysteine increment elevates the relative risk of coronary artery disease risk by a factor (40%) similar to that for an increase in serum cholesterol of 20 mg/dl. 15 The European Concerted Action Project showed that an increased plasma homocysteine level confers a risk of cardiovascular disease similar to that for smoking or hyperlipidemia. Moderately elevated plasma homocysteine levels are observed in the presence of hypertension in patients with cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Homocysteine and hypertension in persons with spinal cord injury

et al. 2005

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Study design: Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers. Objectives: To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI). Setting: Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America). Methods: The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2712.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject. Results: Blood pressure values (Po0.001) and mean arterial pressure (Po0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (Po0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (Po0.05). Conclusions: Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI.

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A Quantitative Assessment of Plasma Homocysteine as a Risk Factor for Vascular Disease

Cited by 2,722 publications

References 87 publications

Folate intake, plasma folate and homocysteine status in a random Finnish population

Folate intake, plasma folate and homocysteine status in a random Finnish population

Homocysteine, methylenetetrahydrofolate reductase and risk of schizophrenia: a meta-analysis

Homocysteine and hypertension in persons with spinal cord injury

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