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Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function.
J Intern Med 2009; 266(2):182-95JI

Abstract

OBJECTIVES

To investigate the relationship between plasma folate, vitamin B12 and total homocysteine concentrations, dietary intake of folate and vitamins B12, B6 and B2, and the risk of first acute myocardial infarction (MI).

DESIGN

Nested case-referent study with up to 13 years of follow-up.

SETTING

The population-based Northern Sweden Health and Disease Study, with 73 879 participants at the time of case ascertainment.

SUBJECTS

A total of 571 MI cases (406 men) and 1569 matched referents. Of the cases, 530 had plasma samples available, and 247 had dietary B-vitamin intake data.

RESULTS

Plasma concentrations of folate were inversely associated, and total homocysteine positively associated, with the risk of MI, independently of each other and of a number of established and novel cardiovascular risk factors, including renal function [multivariate odds ratio for highest vs. lowest quintile of folate 0.52 (95% CI 0.31-0.84), P for trend = 0.036, and homocysteine 1.92 (95% CI 1.20-3.09), P for trend = 0.006]. For plasma vitamin B12 concentrations, and vitamin B12, B6 and B2 intake, no clear risk relationship was apparent. Though not statistically significant, the results for folate intake were consistent with those for plasma concentrations.

CONCLUSIONS

In this large prospective study of a population without mandatory folic acid fortification, both folate and homocysteine were strongly associated with the risk of myocardial infarction, independently of each other and of renal function. Although randomized trials of folic acid supplementation are needed to determine causality, our findings highlight the potential importance of folate, or sources of folate, in incident cardiovascular disease.

Authors+Show Affiliations

Department of Medical Biosciences, Umeå University, Umeå, Sweeden. bethany.van.guelpen@medbio.umu.se

Pub Type(s)

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

Language

eng

PubMed ID

19298497

Citation

Van Guelpen, B, et al. "Plasma Folate and Total Homocysteine Levels Are Associated With the Risk of Myocardial Infarction, Independently of Each Other and of Renal Function." Journal of Internal Medicine, vol. 266, no. 2, 2009, pp. 182-95.
Van Guelpen B, Hultdin J, Johansson I, et al. Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function. J Intern Med. 2009;266(2):182-95.
Van Guelpen, B., Hultdin, J., Johansson, I., Witthöft, C., Weinehall, L., Eliasson, M., ... Winkvist, A. (2009). Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function. Journal of Internal Medicine, 266(2), pp. 182-95. doi:10.1111/j.1365-2796.2009.02077.x.
Van Guelpen B, et al. Plasma Folate and Total Homocysteine Levels Are Associated With the Risk of Myocardial Infarction, Independently of Each Other and of Renal Function. J Intern Med. 2009;266(2):182-95. PubMed PMID: 19298497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma folate and total homocysteine levels are associated with the risk of myocardial infarction, independently of each other and of renal function. AU - Van Guelpen,B, AU - Hultdin,J, AU - Johansson,I, AU - Witthöft,C, AU - Weinehall,L, AU - Eliasson,M, AU - Hallmans,G, AU - Palmqvist,R, AU - Jansson,J-H, AU - Winkvist,A, Y1 - 2009/02/27/ PY - 2009/3/21/entrez PY - 2009/3/21/pubmed PY - 2009/8/14/medline SP - 182 EP - 95 JF - Journal of internal medicine JO - J. Intern. Med. VL - 266 IS - 2 N2 - OBJECTIVES: To investigate the relationship between plasma folate, vitamin B12 and total homocysteine concentrations, dietary intake of folate and vitamins B12, B6 and B2, and the risk of first acute myocardial infarction (MI). DESIGN: Nested case-referent study with up to 13 years of follow-up. SETTING: The population-based Northern Sweden Health and Disease Study, with 73 879 participants at the time of case ascertainment. SUBJECTS: A total of 571 MI cases (406 men) and 1569 matched referents. Of the cases, 530 had plasma samples available, and 247 had dietary B-vitamin intake data. RESULTS: Plasma concentrations of folate were inversely associated, and total homocysteine positively associated, with the risk of MI, independently of each other and of a number of established and novel cardiovascular risk factors, including renal function [multivariate odds ratio for highest vs. lowest quintile of folate 0.52 (95% CI 0.31-0.84), P for trend = 0.036, and homocysteine 1.92 (95% CI 1.20-3.09), P for trend = 0.006]. For plasma vitamin B12 concentrations, and vitamin B12, B6 and B2 intake, no clear risk relationship was apparent. Though not statistically significant, the results for folate intake were consistent with those for plasma concentrations. CONCLUSIONS: In this large prospective study of a population without mandatory folic acid fortification, both folate and homocysteine were strongly associated with the risk of myocardial infarction, independently of each other and of renal function. Although randomized trials of folic acid supplementation are needed to determine causality, our findings highlight the potential importance of folate, or sources of folate, in incident cardiovascular disease. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/19298497/Plasma_folate_and_total_homocysteine_levels_are_associated_with_the_risk_of_myocardial_infarction_independently_of_each_other_and_of_renal_function_ L2 - https://doi.org/10.1111/j.1365-2796.2009.02077.x DB - PRIME DP - Unbound Medicine ER -