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Serum homocysteine and folate but not vitamin B12 are predictors of CHD mortality in older adults.
Eur J Prev Cardiol 2012; 19(6):1420-9EJ

Abstract

AIMS

The associations of serum levels of homocysteine (tHcy), vitamin B(12), and folate with risk of all-cause and coronary heat disease (CHD) mortality is controversial, and the evidence in older adults is limited. The aim of this study was to examine whether serum folate, vitamin B(12), and tHcy independently predict risk of CHD-related and all-cause mortality in older adults.

METHODS AND RESULTS

Serum concentrations of folate, vitamin B(12), and tHcy were determined from blood samples obtained from 3010 Blue Mountains Eye Study participants (1997-99), aged ≥55 years. CHD and all-cause mortality was confirmed using the Australian National Death Index.

RESULTS

Persons in the highest quartile of serum tHcy had increased risk of CHD mortality compared to those in the lowest quartile (multivariable-adjusted hazard ratio, HR, 2.45, 95% CI 1.30-4.62). A significant continuous association was observed between serum tHcy and CHD mortality (HR per SD (= 4.8 µmol/l) increase in serum tHcy 1.25, 95% CI 1.08-1.45), after multivariable-adjustment. A significant association between folate deficiency and CHD-mortality was found (multivariable-adjusted HR 1.53, 95% CI 1.01-2.29). Hyperhomocysteinaemia (>15 µmol/l) was a significant predictor of all-cause mortality (multivariable-adjusted HR 1.47, 95% CI 1.18-1.83). A significant interaction was observed between hyperhomocysteinaemia and folate deficiency for all-cause and CHD mortality (p for interaction = 0.03 and p for interaction = 0.05, respectively).

CONCLUSION

Serum tHcy and folate were independent predictors of CHD and all-cause mortality, while vitamin B(12) was not associated. As raised tHcy levels and folate deficiency are associated with poorer lifestyle, changes to a more healthful lifestyle among older adults may minimize the adverse vascular effects of elevated tHcy.

Authors+Show Affiliations

Centre for Vision Research, University of Sydney,Westmead Hospital, Hawkesbury Rd, Westmead, NSW 2145, Australia.

Pub Type(s)

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

Language

eng

PubMed ID

21960652

Citation

Gopinath, Bamini, et al. "Serum Homocysteine and Folate but Not Vitamin B12 Are Predictors of CHD Mortality in Older Adults." European Journal of Preventive Cardiology, vol. 19, no. 6, 2012, pp. 1420-9.
Gopinath B, Flood VM, Rochtchina E, et al. Serum homocysteine and folate but not vitamin B12 are predictors of CHD mortality in older adults. Eur J Prev Cardiol. 2012;19(6):1420-9.
Gopinath, B., Flood, V. M., Rochtchina, E., Thiagalingam, A., & Mitchell, P. (2012). Serum homocysteine and folate but not vitamin B12 are predictors of CHD mortality in older adults. European Journal of Preventive Cardiology, 19(6), pp. 1420-9. doi:10.1177/1741826711424568.
Gopinath B, et al. Serum Homocysteine and Folate but Not Vitamin B12 Are Predictors of CHD Mortality in Older Adults. Eur J Prev Cardiol. 2012;19(6):1420-9. PubMed PMID: 21960652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum homocysteine and folate but not vitamin B12 are predictors of CHD mortality in older adults. AU - Gopinath,Bamini, AU - Flood,Victoria M, AU - Rochtchina,Elena, AU - Thiagalingam,Aravinda, AU - Mitchell,Paul, Y1 - 2011/09/29/ PY - 2011/10/1/entrez PY - 2011/10/1/pubmed PY - 2013/5/3/medline SP - 1420 EP - 9 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 19 IS - 6 N2 - AIMS: The associations of serum levels of homocysteine (tHcy), vitamin B(12), and folate with risk of all-cause and coronary heat disease (CHD) mortality is controversial, and the evidence in older adults is limited. The aim of this study was to examine whether serum folate, vitamin B(12), and tHcy independently predict risk of CHD-related and all-cause mortality in older adults. METHODS AND RESULTS: Serum concentrations of folate, vitamin B(12), and tHcy were determined from blood samples obtained from 3010 Blue Mountains Eye Study participants (1997-99), aged ≥55 years. CHD and all-cause mortality was confirmed using the Australian National Death Index. RESULTS: Persons in the highest quartile of serum tHcy had increased risk of CHD mortality compared to those in the lowest quartile (multivariable-adjusted hazard ratio, HR, 2.45, 95% CI 1.30-4.62). A significant continuous association was observed between serum tHcy and CHD mortality (HR per SD (= 4.8 µmol/l) increase in serum tHcy 1.25, 95% CI 1.08-1.45), after multivariable-adjustment. A significant association between folate deficiency and CHD-mortality was found (multivariable-adjusted HR 1.53, 95% CI 1.01-2.29). Hyperhomocysteinaemia (>15 µmol/l) was a significant predictor of all-cause mortality (multivariable-adjusted HR 1.47, 95% CI 1.18-1.83). A significant interaction was observed between hyperhomocysteinaemia and folate deficiency for all-cause and CHD mortality (p for interaction = 0.03 and p for interaction = 0.05, respectively). CONCLUSION: Serum tHcy and folate were independent predictors of CHD and all-cause mortality, while vitamin B(12) was not associated. As raised tHcy levels and folate deficiency are associated with poorer lifestyle, changes to a more healthful lifestyle among older adults may minimize the adverse vascular effects of elevated tHcy. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/21960652/Serum_homocysteine_and_folate_but_not_vitamin_B12_are_predictors_of_CHD_mortality_in_older_adults_ L2 - http://journals.sagepub.com/doi/full/10.1177/1741826711424568?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -