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Vitamin status and intake as primary determinants of homocysteinemia in an elderly population.

Abstract

OBJECTIVE

To describe the distribution of plasma homocysteine concentrations in an elderly population and to analyze the relationship between homocysteine level and intake of vitamins and serum levels of vitamins that serve as coenzymes in homocysteine metabolism.

DESIGN

Cross-sectional analysis of homocysteine levels and vitamin blood levels and intake in elderly participants in the Framingham Study.

SETTING

Population-based cohort in Framingham, Mass.

PARTICIPANTS

A total of 1160 adult survivors, aged 67 to 96 years, from the original Framingham Heart Study cohort.

MAIN OUTCOME MEASURES

Plasma homocysteine concentration correlated with plasma folate, vitamin B12, pyridoxal-5'-phosphate (PLP), and oral intakes of these vitamins, and the contribution of these vitamins to the prevalence of elevated homocysteine in the population.

RESULTS

Homocysteine levels were positively correlated with age after controlling for vitamin concentrations. After controlling for age, sex, and levels of other vitamins, homocysteine exhibited a strong inverse association with plasma folate. When subjects were grouped by deciles of plasma folate, mean homocysteine was significantly higher in the lowest two folate deciles (15.6 and 13.7 mumol/L, respectively) than in the highest decile (11.0 mumol/L). Homocysteine demonstrated weaker, inverse associations with plasma vitamin B12 and PLP. Similar inverse associations were demonstrated between homocysteine and intakes of folate and vitamin B6, but not vitamin B12. Prevalence of high homocysteine (> 14 mumol/L) was 29.3% in this cohort, and was greatest among subjects with low folate status. Inadequate plasma concentrations of one or more B vitamins appear to contribute to 67% of the cases of high homocysteine.

CONCLUSIONS

These results indicate a strong association between homocysteine concentration and folate, vitamin B12, and vitamin B6 status, as well as age. It is possible that a substantial majority of the cases of high homocysteine in this older population can be attributed to vitamin status.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111.

    , , ,

    Source

    JAMA 270:22 1993 Dec 08 pg 2693-8

    MeSH

    Aged
    Aged, 80 and over
    Aging
    Cohort Studies
    Female
    Folic Acid
    Homocysteine
    Humans
    Male
    Nutritional Status
    Pyridoxal Phosphate
    Pyridoxine
    Vitamin B 12
    Vitamin B Complex

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    8133587

    Citation

    Selhub, J, et al. "Vitamin Status and Intake as Primary Determinants of Homocysteinemia in an Elderly Population." JAMA, vol. 270, no. 22, 1993, pp. 2693-8.
    Selhub J, Jacques PF, Wilson PW, et al. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA. 1993;270(22):2693-8.
    Selhub, J., Jacques, P. F., Wilson, P. W., Rush, D., & Rosenberg, I. H. (1993). Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA, 270(22), pp. 2693-8.
    Selhub J, et al. Vitamin Status and Intake as Primary Determinants of Homocysteinemia in an Elderly Population. JAMA. 1993 Dec 8;270(22):2693-8. PubMed PMID: 8133587.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. AU - Selhub,J, AU - Jacques,P F, AU - Wilson,P W, AU - Rush,D, AU - Rosenberg,I H, PY - 1993/12/8/pubmed PY - 1993/12/8/medline PY - 1993/12/8/entrez SP - 2693 EP - 8 JF - JAMA JO - JAMA VL - 270 IS - 22 N2 - OBJECTIVE: To describe the distribution of plasma homocysteine concentrations in an elderly population and to analyze the relationship between homocysteine level and intake of vitamins and serum levels of vitamins that serve as coenzymes in homocysteine metabolism. DESIGN: Cross-sectional analysis of homocysteine levels and vitamin blood levels and intake in elderly participants in the Framingham Study. SETTING: Population-based cohort in Framingham, Mass. PARTICIPANTS: A total of 1160 adult survivors, aged 67 to 96 years, from the original Framingham Heart Study cohort. MAIN OUTCOME MEASURES: Plasma homocysteine concentration correlated with plasma folate, vitamin B12, pyridoxal-5'-phosphate (PLP), and oral intakes of these vitamins, and the contribution of these vitamins to the prevalence of elevated homocysteine in the population. RESULTS: Homocysteine levels were positively correlated with age after controlling for vitamin concentrations. After controlling for age, sex, and levels of other vitamins, homocysteine exhibited a strong inverse association with plasma folate. When subjects were grouped by deciles of plasma folate, mean homocysteine was significantly higher in the lowest two folate deciles (15.6 and 13.7 mumol/L, respectively) than in the highest decile (11.0 mumol/L). Homocysteine demonstrated weaker, inverse associations with plasma vitamin B12 and PLP. Similar inverse associations were demonstrated between homocysteine and intakes of folate and vitamin B6, but not vitamin B12. Prevalence of high homocysteine (> 14 mumol/L) was 29.3% in this cohort, and was greatest among subjects with low folate status. Inadequate plasma concentrations of one or more B vitamins appear to contribute to 67% of the cases of high homocysteine. CONCLUSIONS: These results indicate a strong association between homocysteine concentration and folate, vitamin B12, and vitamin B6 status, as well as age. It is possible that a substantial majority of the cases of high homocysteine in this older population can be attributed to vitamin status. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/8133587/Vitamin_status_and_intake_as_primary_determinants_of_homocysteinemia_in_an_elderly_population_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/270/pg/2693 DB - PRIME DP - Unbound Medicine ER -