Plasma homocysteine and menopausal status**

Wouters, M.G.A.J.; Moorrees, M.T.E.C.; Mooren, M.J. van der; Blom, Henk J.; Boers, G.H.J.; Schellekens, L. A.; Thomas, Chris M.G.; Eskes, T.K.A.B.

doi:10.1111/j.1365-2362.1995.tb01687.x

Cited by 201 publications

(105 citation statements)

References 30 publications

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“…After the menopause female homocysteine levels become more comparable with those of the male Brattstrom et al 1985Brattstrom et al , 1990Kang et al 1986a;Wouters et al 1995;Verhoef et al 1999). It is well established that homocysteine levels increase with age (Kang et al 1986a;Andersson et al 1992;Brattstrom et al 1992aBrattstrom et al , 1994Selhub et al 1993;Robinson et al 1995;Nygard et al 1995Nygard et al , 1998Vilaseca et al 1997); this increase may be due to a decline in renal function (Brattstrom et al 1994;Wu et al 1994) or intake and status of the B-vitamin cofactors (Selhub et al 1993;Brattstrom et al 1994;Koehler et al 1996) with increasing age.…”

Section: Age and Sexmentioning

confidence: 99%

Nutritional aspects and possible pathological mechanisms of hyperhomocysteinaemia: an independent risk factor for vascular disease

McKinley

2000

Proc. Nutr. Soc.

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Numerous case–control and prospective studies have identified elevated plasma homocysteine as a strong independent risk factor for cerebovascular, cardiovascular and peripheral vascular disease. Homocysteine is formed as a result of the breakdown of the dietary amino acid methionine. Once formed, homocysteine is either remethylated to methionine, or undergoes a trans-sulfuration reaction to form cysteine. The re-methylation of homocysteine to methionine is dependent on three B-vitamins, i.e. riboflavin, vitamin B12and folate. The second pathway of homocysteine metabolism is the trans-sulfuration pathway which requires both vitamin B6and riboflavin for its activity. Thus, up to four B-vitamins are required for intracellular homocysteine metabolism. Many studies have noted strong inverse relationships between homocysteine levels and the status of both vitamin B12and folate. However, the relationship between vitamin B6status and homocysteine is still uncertain. Similarly, numerous intervention studies have demonstrated effective lowering of homocysteine levels as a result of folate and vitamin B12supplementation, while the homocysteine-lowering ability of vitamin B6is unclear. Even though riboflavin plays a crucial role in both the trans-sulfuration and remethylation pathways of homocysteine metabolism, the relationship between riboflavin status and homocysteine levels has not been investigated. The exact mechanism that explains the vascular toxicity of elevated homocysteine levels is unknown at present, studies indicate that it is both atherogenic and thrombogenic. To date, no randomized clinical trial has demonstrated that lowering of homocysteine levels is beneficial in terms of reducing the prevalence of vascular disease. It is probable, however, that optimal B-vitamin status is important in the prevention of vascular disease.

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Section: Age and Sexmentioning

confidence: 99%

Nutritional aspects and possible pathological mechanisms of hyperhomocysteinaemia: an independent risk factor for vascular disease

McKinley

2000

Proc. Nutr. Soc.

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“…It was demonstrated that plasma homo cysteine concentrations in postmenopausal women are higher than in premenopausal women and there fore may contribute to the increased cardiovascular risk in postmenopausal women (16). Furthermore, postmenopausal E2/dydrogesterone administration for 2 years was associated with a decrease in serum homocysteine, which may contribute to the cardio protective effect of HRT (17).…”

Section: Homocysteinementioning

confidence: 99%

“…Its reported increase after meno pause has been suggested to explain part of the in creased risk of developing CVD in postmenopausal women (16). The recently published data on de creased homocysteine levels during HRT (17) may indeed partially account for the decreased risk in CVD during postmenopausal HRT.…”

mentioning

confidence: 93%

The effect of sequential three-monthly hormone replacement therapy on several cardiovascular risk estimators in postmenopausal women

Mooren¹,

Demacker²,

Blom³

et al. 1997

Fertility and Sterility

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Objective: To investigate the changes in plasma lipids and lipoproteins, low-density lipopro tein (LDL) oxidizability, and plasma homocysteine during postmenopausal sequential 3-monthly hormone replacement therapy.Design: Open longitudinal prospective study. Setting: Gynecological outpatient departm ent of a university hospital. P atient(s): Thirty-nine healthy nonhysterectomized postmenopausal women.In terv en tion (s): Oral conjugated estrogen, 0.625 mg/d, combined with oral medrogestone 10 mg/d during the last 14 days of each 84-day treatm ent cycle, The treatm ent was given for four treatm ent cycles of 84 days (1 year). M ain Outcom e Measure(s): Plasma lipids and lipoproteins, LDL oxidizability, and plasma homocysteine.R es uit (s): After 1 year of treatm ent plasma concentrations of total cholesterol and LDL cholesterol were 3.5% and 8.7% lower, respectively. High density lipoprotein cholesterol, apolipoprotein A-I, and triglycerides were 6.5%, 9.0% and 16% higher, respectively. Apolipoprotein B concentration remained unchanged. The results on LDL oxidizability were inconsistent. Plasma homocysteine decreased with 12.3% during the first 6 months of treatm ent in women with higher homocysteine concentrations at baseline. These values returned to baseline levels during the second half year of treatm ent. Conclusion(s):This sequential hormone regimen induced beneficial changes in the conven tional lipid and lipoprotein risk estimators, whereas the observed changes in the other markers remained inconclusive and/or of minor importance.Fértil in postmenopausal women (1, 2). Furthermore, it has been reported to reduce the incidence of osteopo rotic fractures (2) and of cardiovascular disease (2, 3). To accomplish the latter two preventive effects of HRT, long-term supplementation is recommended in selected groups of subjects at increased risk (2), To prevent the development of endometrial hyper plasia and carcinoma in nonhysterectomized women the addition of progestogen to the estrogen adminis tration is recommended (4). A disadvantage of se quential estrogen-progestogen therapy, however, is that it restores vaginal bleeding, which is an im portant reason for poor compliance in many women (5). Therefore, alternative treatment regimens, such as continuous combined estrogen/progestogen regi men and 3-monthly progestogen administration dur ing estrogen supplementation (6, 7), currently are

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“…Generally, fasting tHcy levels are lower in women than in men [5][6][7][8][9][10][11] . Some studies [12][13][14][15][16] , but not all [11] , have reported higher tHcy levels in post-menopausal than in pre-menopausal women, which may even exceed those in men of the same age. It has been suggested that this may, in part, account for the markedly increased risk of vascular disease in women after the menopause [17] .…”

Section: Introductionmentioning

confidence: 96%

Homocysteine, vitamin status and risk of vascular disease; effects of gender and menopausal status

Verhoef¹,

Meleady²,

Daly³

et al. 1999

European Heart Journal

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Background Elevated plasma total homocysteine (tHcy) is a known risk factor for vascular disease. Gender, age, and circulating levels of folate, vitamins B 6 and B 12 affect tHcy levels.Objectives To study associations of gender and age with levels of plasma tHcy, and to examine the relationships of tHcy and circulating levels of folate, vitamins B 6 and B 12 with risk of vascular disease in men and women (pre-and post-menopausal). Material and methodsIn a multicentre case-control study in Europe, 750 patients (544 men, 206 women) with documented vascular disease of the coronary, cerebral, or peripheral vessels and 800 control subjects (570 men, 230 women) were enrolled. Plasma tHcy levels (fasting and after methionine loading) and circulating levels of the vitamins were measured. Adjustment for age and centre was carried out for all statistical analyses, with additional adjustment for serum creatinine and vitamins for the tHcy comparisons between the sexes and between cases and controls. Risk analyses included adjustment for creatinine and traditional risk factors. Relationships between age, gender and tHcy were studied among control subjects only.Results Fasting tHcy levels were lower in women than in men. Levels of tHcy showed a positive association with age, for both sexes. In the post-menopausal age category, female post-methionine load tHcy levels surpassed levels of men. Elevation of tHcy (defined as >80th percentile of controls) appeared to be at least as strong a risk factor for vascular disease in women as in men, even before the menopause. For post-methionine load tHcy, there was a 40% stronger association with vascular disease in women than in men. In both sexes, but especially in pre-menopausal women, low circulating levels of vitamin B 6 conferred a two-to threefold increased risk of vascular disease, independent of tHcy. In men, but not in women, low (defined as <20th percentile of controls) circulating folate levels were associated with a 50% increased risk of vascular disease. ConclusionsElevation of tHcy appears to be at least as strong a risk for vascular disease in women as men, even before the menopause. Our data indicate that associations of the various tHcy measurements (and the vitamins that determine them), with risks of vascular disease may differ between the sexes. The tHcy-independent relationship of vitamin B 6 with vascular disease indicates that it will be advisable to test the effects of vitamin B 6 in clinical trials. (Eur Heart J 1999; 20: 1234-1244)

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Plasma homocysteine and menopausal status**

Cited by 201 publications

References 30 publications

Nutritional aspects and possible pathological mechanisms of hyperhomocysteinaemia: an independent risk factor for vascular disease

Nutritional aspects and possible pathological mechanisms of hyperhomocysteinaemia: an independent risk factor for vascular disease

The effect of sequential three-monthly hormone replacement therapy on several cardiovascular risk estimators in postmenopausal women

Homocysteine, vitamin status and risk of vascular disease; effects of gender and menopausal status

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