Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over

Abstract

Predictive power, for total and vascular mortality, of selected indices measured at baseline in the British National Diet and Nutrition Survey (community-living subset) of People Aged 65 Years and Over was tested. Mortality status and its primary and underlying causes were recorded for 1100 (mean age 76·7 (SD 7·5) years, 50·2 % females) respondents from the baseline survey in 1994-5 until September 2008. Follow-up data analyses focussed especially on known predictors of vascular disease risk, together with intakes and status indices of selected nutrients known to affect, or to be affected by, these predictors. Total mortality was significantly predicted by hazard ratios of baseline plasma concentrations (per SD) of total homocysteine (tHcy) (95 % CI) 1·19 (1·11, 1·27), pyridoxal phosphate 0·90 (0·81, 1·00), pyridoxic acid 1·10 (1·03, 1·19), a 1 -antichymotrypsin 1·21 (1·13, 1·29), fibrinogen 1·14 (1·05, 1·23), creatinine 1·20 (1·10, 1·31) and glycosylated Hb 1·23 (1·14, 1·32), and by dietary intakes of energy 0·87 (0·80, 0·96) and protein 0·86 (0·77, 0·97). Prediction patterns and significance were similar for primary-cause vascular mortality. The traditional risk predictors plasma total and HDL cholesterol were not significant mortality predictors in this age group, nor were the known tHcy-regulating nutrients, folate and vitamin B 12 (intakes and status indices). Model adjustment for known risk predictors resulted in the loss of significance for some of the afore-mentioned indices; however, tHcy 1·34 (1·04, 1·73) remained a significant predictor for vascular mortality. Thus, total and primary vascular mortality is predicted by energy and protein intakes, and by biochemical indices including tHcy, independent of serum folate or vitamin B 12 .

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…The insufficiency in Vitamin B 12 results in the accumulation of Hcy, which is known as HHcy. HHcy is a well-established risk factor for cardiovascular diseases, cognitive impairment, and chronic renal failure [4][5][6][7][8][9], moreover, Hcy has been found to be an independent predictor of all-cause and vascular mortality [38,39]. Metformin has been demonstrated to be associated with reduction of serum Vitamin B 12 concentration [3,40].…”

Effects of Two-Year Vitamin B12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT

“…Hyperhomocysteinemia has been associated with various adverse health conditions, including cardiovascular disease [6], fractures [7], dementia [8], decreased physical functioning [9], and mortality [10]. In addition, observational studies suggest a link between elevated Hcy concentrations and depressive symptoms [11,12,13,14] and lower HR-QoL [15,16].…”

Early Biochemical and Hematological Response to Intramuscular Cyanocobalamin Therapy in Vitamin B₁₂-Deficient Patients

“…Hyperhomocysteinemia is also associated with increased mortality in the elderly [9,10,11,12]. A number of studies have suggested that endothelial dysfunction and oxidation of low-density lipoprotein is linked to hyperhomocysteinemia [9,10,11,12].…”