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Public health significance of elevated homocysteine.

Abstract

Homocysteine is a sulfur amino acid whose metabolism stands at the intersection of two pathways: remethylation, which requires folic acid and vitamin B12 coenzymes; and transsulfuration, which requires pyridoxal-5'-phosphate, the vitamin B6 coenzyme. Data from a number of laboratories suggest that mild elevations of homocysteine in plasma are a risk factor for occlusive vascular disease. In the Framingham studies, we have shown that plasma homocysteine concentration is inversely related to the intake and plasma levels of folate and vitamin B6 as well as vitamin B12 plasma levels. Almost two-thirds of the prevalence of high homocysteine is attributable to low vitamin status or intake. Elevated homocysteine concentrations in plasma are a risk factor for prevalence of extracranial carotid-artery stenosis > or = 25% in both men and women. Prospectively elevated plasma homocysteine is associated with increased total and cardiovascular mortality, increased incidence of stroke, increased incidence of dementia and Alzheimer's disease, increased incidence of bone fracture, and higher prevalence of chronic heart failure. It was also shown that elevated plasma homocysteine is a risk factor for preeclampsia and maybe neural tube defects (NTD). This multitude of relationships between elevated plasma homocysteine and diseases that afflict the elderly, pregnant women, and the embryo points to the existence ofa common denominator which may be responsible for these diseases. Whether this denominator is homocysteine itself or homocysteine is merely a marker, remains to be determined.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA. jacob.selhub@tufts.edu

    Source

    Food and nutrition bulletin 29:2 Suppl 2008 Jun pg S116-25

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Cardiovascular Diseases
    Dementia
    Diet
    Female
    Folic Acid
    Fractures, Bone
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Male
    Middle Aged
    Neural Tube Defects
    Pregnancy
    Public Health
    Risk Factors
    Vitamin B 12
    Vitamin B 6

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18709886

    Citation

    Selhub, Jacob. "Public Health Significance of Elevated Homocysteine." Food and Nutrition Bulletin, vol. 29, no. 2 Suppl, 2008, pp. S116-25.
    Selhub J. Public health significance of elevated homocysteine. Food Nutr Bull. 2008;29(2 Suppl):S116-25.
    Selhub, J. (2008). Public health significance of elevated homocysteine. Food and Nutrition Bulletin, 29(2 Suppl), pp. S116-25.
    Selhub J. Public Health Significance of Elevated Homocysteine. Food Nutr Bull. 2008;29(2 Suppl):S116-25. PubMed PMID: 18709886.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Public health significance of elevated homocysteine. A1 - Selhub,Jacob, PY - 2008/8/20/pubmed PY - 2008/11/11/medline PY - 2008/8/20/entrez SP - S116 EP - 25 JF - Food and nutrition bulletin JO - Food Nutr Bull VL - 29 IS - 2 Suppl N2 - Homocysteine is a sulfur amino acid whose metabolism stands at the intersection of two pathways: remethylation, which requires folic acid and vitamin B12 coenzymes; and transsulfuration, which requires pyridoxal-5'-phosphate, the vitamin B6 coenzyme. Data from a number of laboratories suggest that mild elevations of homocysteine in plasma are a risk factor for occlusive vascular disease. In the Framingham studies, we have shown that plasma homocysteine concentration is inversely related to the intake and plasma levels of folate and vitamin B6 as well as vitamin B12 plasma levels. Almost two-thirds of the prevalence of high homocysteine is attributable to low vitamin status or intake. Elevated homocysteine concentrations in plasma are a risk factor for prevalence of extracranial carotid-artery stenosis > or = 25% in both men and women. Prospectively elevated plasma homocysteine is associated with increased total and cardiovascular mortality, increased incidence of stroke, increased incidence of dementia and Alzheimer's disease, increased incidence of bone fracture, and higher prevalence of chronic heart failure. It was also shown that elevated plasma homocysteine is a risk factor for preeclampsia and maybe neural tube defects (NTD). This multitude of relationships between elevated plasma homocysteine and diseases that afflict the elderly, pregnant women, and the embryo points to the existence ofa common denominator which may be responsible for these diseases. Whether this denominator is homocysteine itself or homocysteine is merely a marker, remains to be determined. SN - 0379-5721 UR - https://www.unboundmedicine.com/medline/citation/18709886/Public_health_significance_of_elevated_homocysteine_ L2 - http://journals.sagepub.com/doi/full/10.1177/15648265080292S116?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -