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Homocysteine or renal impairment: which is the real cardiovascular risk factor?
Arterioscler Thromb Vasc Biol 2008; 28(6):1158-64AT

Abstract

OBJECTIVE

The purpose of this study was to determine whether adjustment for renal function eliminates the relationship between total plasma homocysteine (tHcy) and vascular risk, assessed by carotid intima medial thickness (CIMT) and flow-mediated dilation (FMD) of the brachial artery.

METHODS AND RESULTS

We used cross-sectional data from 173 stroke patients treated with B-vitamins (folic acid 2 mg, vitamin B(6) 25 mg, and vitamin B(12) 0.5 mg) or placebo in a randomized double-blinded trial to test the relationships between posttreatment tHcy, cystatin C (a marker of glomerular filtration rate), estimated glomerular filtration rate (eGFR, Modification of Diet in Renal Disease equation) creatinine, CIMT, and FMD in stepwise and multivariable regression models. The strong linear relationship between tHcy and cystatin C was not altered by long-term B-vitamin treatment. tHcy lost significance as a predictor of the vascular measurements after adjustment for any single marker of renal function. Cystatin C, but not tHcy, was a significant independent predictor of FMD after adjustment for age, sex, smoking, systolic blood pressure, high-density lipoprotein cholesterol, and treatment group.

CONCLUSIONS

Adjusting for renal function eliminates the relationship between tHcy and CIMT and FMD, supporting the hypothesis that elevated tHcy is a marker for renal impairment rather than an independent cardiovascular risk factor.

Authors+Show Affiliations

Department of Cardiology, Level 4, A Block, Royal Perth Hospital, Perth WA6847, Australia. pottek04@cyllene.uwa.edu.auNo 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

18356552

Citation

Potter, Kathleen, et al. "Homocysteine or Renal Impairment: Which Is the Real Cardiovascular Risk Factor?" Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 28, no. 6, 2008, pp. 1158-64.
Potter K, Hankey GJ, Green DJ, et al. Homocysteine or renal impairment: which is the real cardiovascular risk factor? Arterioscler Thromb Vasc Biol. 2008;28(6):1158-64.
Potter, K., Hankey, G. J., Green, D. J., Eikelboom, J. W., & Arnolda, L. F. (2008). Homocysteine or renal impairment: which is the real cardiovascular risk factor? Arteriosclerosis, Thrombosis, and Vascular Biology, 28(6), pp. 1158-64. doi:10.1161/ATVBAHA.108.162743.
Potter K, et al. Homocysteine or Renal Impairment: Which Is the Real Cardiovascular Risk Factor. Arterioscler Thromb Vasc Biol. 2008;28(6):1158-64. PubMed PMID: 18356552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine or renal impairment: which is the real cardiovascular risk factor? AU - Potter,Kathleen, AU - Hankey,Graeme J, AU - Green,Daniel J, AU - Eikelboom,John W, AU - Arnolda,Leonard F, Y1 - 2008/03/20/ PY - 2008/3/22/pubmed PY - 2008/6/11/medline PY - 2008/3/22/entrez SP - 1158 EP - 64 JF - Arteriosclerosis, thrombosis, and vascular biology JO - Arterioscler. Thromb. Vasc. Biol. VL - 28 IS - 6 N2 - OBJECTIVE: The purpose of this study was to determine whether adjustment for renal function eliminates the relationship between total plasma homocysteine (tHcy) and vascular risk, assessed by carotid intima medial thickness (CIMT) and flow-mediated dilation (FMD) of the brachial artery. METHODS AND RESULTS: We used cross-sectional data from 173 stroke patients treated with B-vitamins (folic acid 2 mg, vitamin B(6) 25 mg, and vitamin B(12) 0.5 mg) or placebo in a randomized double-blinded trial to test the relationships between posttreatment tHcy, cystatin C (a marker of glomerular filtration rate), estimated glomerular filtration rate (eGFR, Modification of Diet in Renal Disease equation) creatinine, CIMT, and FMD in stepwise and multivariable regression models. The strong linear relationship between tHcy and cystatin C was not altered by long-term B-vitamin treatment. tHcy lost significance as a predictor of the vascular measurements after adjustment for any single marker of renal function. Cystatin C, but not tHcy, was a significant independent predictor of FMD after adjustment for age, sex, smoking, systolic blood pressure, high-density lipoprotein cholesterol, and treatment group. CONCLUSIONS: Adjusting for renal function eliminates the relationship between tHcy and CIMT and FMD, supporting the hypothesis that elevated tHcy is a marker for renal impairment rather than an independent cardiovascular risk factor. SN - 1524-4636 UR - https://www.unboundmedicine.com/medline/citation/18356552/Homocysteine_or_renal_impairment:_which_is_the_real_cardiovascular_risk_factor L2 - http://www.ahajournals.org/doi/full/10.1161/ATVBAHA.108.162743?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -