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Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration.
Nutrition 2003 Jul-Aug; 19(7-8):577-83N

Abstract

OBJECTIVES

The purposes of this study were to study the effects of folate and vitamins B6 and B12 on plasma homocysteine concentration and to estimate the risks for coronary artery disease (CAD) according to quartiles of plasma homocysteine concentration.

METHODS

The study was designed as a case-reference observational study. Case subjects (CAD group, n = 60) were identified by cardiac catheterization to have at least 70% stenosis of one major coronary artery; otherwise, patients were considered for a reference group (n = 60). Risk factors of cardiovascular disease were recorded, including age, sex, blood lipid profile, hypertension, smoking habits, and drinking habits. Plasma homocysteine, folate, pyridoxal 5'-phosphate, and vitamin B12 were measured.

RESULTS

CAD subjects had significantly higher mean plasma homocysteine concentrations than did the reference subjects (13.9 +/- 4.9 versus 9.1 +/- 3.3 micromol/L). There were no significant differences between groups with regard to the three B vitamins; however, mean serum folate concentrations for subjects in the highest two quartiles of plasma homocysteine concentration (10.8-13.8 and >/=13.9 micromol/L) were significantly lower than those for subjects in the lowest two quartiles (</=8.0 and 8.1-10.7 micromol/L). Plasma homocysteine was strongly inversely associated with serum folate in the CAD (beta= -0.166, P < 0.05), reference (beta= -0.178, P < 0.001), and pooled (beta = -0.190, P < 0.001) groups. Age, sex, other confounding factors, and B-vitamin-adjusted odds ratios were significantly increased in the highest quartile of homocysteine concentration (odds ration, 5.54; 95% confidence interval, 0.38-81.41). The elevation of 1 ng/mL in serum folate concentration was found to decrease plasma homocysteine by 0.166 micromol/L.

CONCLUSIONS

Serum folate, but not vitamin B6 or B12, was a strong predictor of plasma homocysteine; while all subjects had adequate B-vitamin status. Folate should be considered as a routine supplementation for individuals who have risk factors for CAD, even for individuals with adequate folate status.

Authors+Show Affiliations

Intensive Care Unit, Critical Care and Respiratory Therapy, Taichung Veterans General Hospital, Taiwan, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12831941

Citation

Lee, Bor Jen, et al. "Homocysteine and Risk of Coronary Artery Disease: Folate Is the Important Determinant of Plasma Homocysteine Concentration." Nutrition (Burbank, Los Angeles County, Calif.), vol. 19, no. 7-8, 2003, pp. 577-83.
Lee BJ, Lin PT, Liaw YP, et al. Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration. Nutrition. 2003;19(7-8):577-83.
Lee, B. J., Lin, P. T., Liaw, Y. P., Chang, S. J., Cheng, C. H., & Huang, Y. C. (2003). Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration. Nutrition (Burbank, Los Angeles County, Calif.), 19(7-8), pp. 577-83.
Lee BJ, et al. Homocysteine and Risk of Coronary Artery Disease: Folate Is the Important Determinant of Plasma Homocysteine Concentration. Nutrition. 2003;19(7-8):577-83. PubMed PMID: 12831941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration. AU - Lee,Bor Jen, AU - Lin,Ping Ting, AU - Liaw,Yung Po, AU - Chang,Sue Joan, AU - Cheng,Chien Hsiung, AU - Huang,Yi Chia, PY - 2003/7/2/pubmed PY - 2004/1/6/medline PY - 2003/7/2/entrez SP - 577 EP - 83 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 19 IS - 7-8 N2 - OBJECTIVES: The purposes of this study were to study the effects of folate and vitamins B6 and B12 on plasma homocysteine concentration and to estimate the risks for coronary artery disease (CAD) according to quartiles of plasma homocysteine concentration. METHODS: The study was designed as a case-reference observational study. Case subjects (CAD group, n = 60) were identified by cardiac catheterization to have at least 70% stenosis of one major coronary artery; otherwise, patients were considered for a reference group (n = 60). Risk factors of cardiovascular disease were recorded, including age, sex, blood lipid profile, hypertension, smoking habits, and drinking habits. Plasma homocysteine, folate, pyridoxal 5'-phosphate, and vitamin B12 were measured. RESULTS: CAD subjects had significantly higher mean plasma homocysteine concentrations than did the reference subjects (13.9 +/- 4.9 versus 9.1 +/- 3.3 micromol/L). There were no significant differences between groups with regard to the three B vitamins; however, mean serum folate concentrations for subjects in the highest two quartiles of plasma homocysteine concentration (10.8-13.8 and >/=13.9 micromol/L) were significantly lower than those for subjects in the lowest two quartiles (</=8.0 and 8.1-10.7 micromol/L). Plasma homocysteine was strongly inversely associated with serum folate in the CAD (beta= -0.166, P < 0.05), reference (beta= -0.178, P < 0.001), and pooled (beta = -0.190, P < 0.001) groups. Age, sex, other confounding factors, and B-vitamin-adjusted odds ratios were significantly increased in the highest quartile of homocysteine concentration (odds ration, 5.54; 95% confidence interval, 0.38-81.41). The elevation of 1 ng/mL in serum folate concentration was found to decrease plasma homocysteine by 0.166 micromol/L. CONCLUSIONS: Serum folate, but not vitamin B6 or B12, was a strong predictor of plasma homocysteine; while all subjects had adequate B-vitamin status. Folate should be considered as a routine supplementation for individuals who have risk factors for CAD, even for individuals with adequate folate status. SN - 0899-9007 UR - https://www.unboundmedicine.com/medline/citation/12831941/Homocysteine_and_risk_of_coronary_artery_disease:_Folate_is_the_important_determinant_of_plasma_homocysteine_concentration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899900702010985 DB - PRIME DP - Unbound Medicine ER -