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Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake.
Stroke 2005; 36(7):1426-31S

Abstract

BACKGROUND AND PURPOSE

Folate metabolism has been implicated in stroke. However, the possibility of a role for folate and vitamin B12, independent of their effects on homocysteine status, remains to be explored. The aim of this prospective, nested case-referent study was to relate plasma and dietary intake levels of folate and vitamin B12 to risk of stroke, taking into consideration plasma homocysteine concentrations and methylenetetrahydrofolate reductase polymorphisms.

METHODS

Subjects were 334 ischemic and 62 hemorrhagic stroke cases and matched double referents from the population-based Northern Sweden Health and Disease Cohort.

RESULTS

Plasma folate was statistically significantly associated with risk of hemorrhagic stroke in an inverse linear manner, both in univariate analysis and after adjustment for conventional risk factors including hypertension (odds ratio [OR] for highest versus lowest quartile 0.21 (95% confidence interval [CI], 0.06 to 0.71; P for trend=0.008)). Risk estimates were attenuated by inclusion of homocysteine in the model (OR, 0.34; 95% CI, 0.08 to 1.40; P for trend=0.088). A similar pattern was observed for increasing folate intake (multivariate OR, 0.07; 95% CI, 0.01 to 0.55; P for trend=0.031 without homocysteine, and OR, 0.16, 95% CI, 0.02 to 1.23; P for trend=0.118 with homocysteine in the analysis). We found little evidence of an association between plasma or dietary folate and risk of ischemic stroke. Neither plasma nor dietary vitamin B12 was associated with risk of either stroke subtype.

CONCLUSIONS

The results of this study suggest a protective role for folate, possibly in addition to its effects on homocysteine status, in hemorrhagic but not ischemic stroke.

Authors+Show Affiliations

Department of Medical Biosciences, Umeå University Hospital, Umeå, Sweden. Bethany.Van.Guelpen@nutrires.umu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

15933256

Citation

Van Guelpen, Bethany, et al. "Folate, Vitamin B12, and Risk of Ischemic and Hemorrhagic Stroke: a Prospective, Nested Case-referent Study of Plasma Concentrations and Dietary Intake." Stroke, vol. 36, no. 7, 2005, pp. 1426-31.
Van Guelpen B, Hultdin J, Johansson I, et al. Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake. Stroke. 2005;36(7):1426-31.
Van Guelpen, B., Hultdin, J., Johansson, I., Stegmayr, B., Hallmans, G., Nilsson, T. K., ... Winkvist, A. (2005). Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake. Stroke, 36(7), pp. 1426-31.
Van Guelpen B, et al. Folate, Vitamin B12, and Risk of Ischemic and Hemorrhagic Stroke: a Prospective, Nested Case-referent Study of Plasma Concentrations and Dietary Intake. Stroke. 2005;36(7):1426-31. PubMed PMID: 15933256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake. AU - Van Guelpen,Bethany, AU - Hultdin,Johan, AU - Johansson,Ingegerd, AU - Stegmayr,Birgitta, AU - Hallmans,Göran, AU - Nilsson,Torbjörn K, AU - Weinehall,Lars, AU - Witthöft,Cornelia, AU - Palmqvist,Richard, AU - Winkvist,Anna, Y1 - 2005/06/02/ PY - 2005/6/4/pubmed PY - 2005/12/13/medline PY - 2005/6/4/entrez SP - 1426 EP - 31 JF - Stroke JO - Stroke VL - 36 IS - 7 N2 - BACKGROUND AND PURPOSE: Folate metabolism has been implicated in stroke. However, the possibility of a role for folate and vitamin B12, independent of their effects on homocysteine status, remains to be explored. The aim of this prospective, nested case-referent study was to relate plasma and dietary intake levels of folate and vitamin B12 to risk of stroke, taking into consideration plasma homocysteine concentrations and methylenetetrahydrofolate reductase polymorphisms. METHODS: Subjects were 334 ischemic and 62 hemorrhagic stroke cases and matched double referents from the population-based Northern Sweden Health and Disease Cohort. RESULTS: Plasma folate was statistically significantly associated with risk of hemorrhagic stroke in an inverse linear manner, both in univariate analysis and after adjustment for conventional risk factors including hypertension (odds ratio [OR] for highest versus lowest quartile 0.21 (95% confidence interval [CI], 0.06 to 0.71; P for trend=0.008)). Risk estimates were attenuated by inclusion of homocysteine in the model (OR, 0.34; 95% CI, 0.08 to 1.40; P for trend=0.088). A similar pattern was observed for increasing folate intake (multivariate OR, 0.07; 95% CI, 0.01 to 0.55; P for trend=0.031 without homocysteine, and OR, 0.16, 95% CI, 0.02 to 1.23; P for trend=0.118 with homocysteine in the analysis). We found little evidence of an association between plasma or dietary folate and risk of ischemic stroke. Neither plasma nor dietary vitamin B12 was associated with risk of either stroke subtype. CONCLUSIONS: The results of this study suggest a protective role for folate, possibly in addition to its effects on homocysteine status, in hemorrhagic but not ischemic stroke. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/15933256/Folate_vitamin_B12_and_risk_of_ischemic_and_hemorrhagic_stroke:_a_prospective_nested_case_referent_study_of_plasma_concentrations_and_dietary_intake_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000169934.96354.3a?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -