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Plasma total cysteine as a risk factor for vascular disease: The European Concerted Action Project

L El-Khairy1, P M Ueland, H Refsum

  • 1LOCUS for Homocysteine and Related Vitamins, University of Bergen, Bergen, Norway. lina.el-khairy@smis.uib.no

Circulation
|May 31, 2001
PubMed

Insights

Plasma total cysteine (tCys) shows a U-shaped link to vascular disease risk, with both low and high levels increasing risk. This contrasts with total homocysteine (tHcy), a known cardiovascular risk factor.

Area of Science:

  • Biochemistry
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Elevated plasma total homocysteine (tHcy) is a recognized cardiovascular disease (CVD) risk factor.
  • The association between plasma total cysteine (tCys) and CVD risk remains under-investigated despite metabolic links to tHcy.

Purpose of the Study:

  • To investigate the relationship between plasma total cysteine (tCys) levels and the risk of vascular disease across coronary, cerebral, and peripheral vessels.

Main Methods:

  • A case-control study involving 750 vascular disease patients and 800 controls across 9 European countries.
  • Measured plasma levels of tCys, tHcy, folate, B(6), B(12), and creatinine.
  • Adjusted for conventional cardiovascular disease risk factors.

Main Results:

  • A significant U-shaped relationship was observed between tCys levels and overall vascular disease risk.
  • Low tCys levels (
  • High tCys levels (>300 micromol/L) showed an adjusted risk of 1.6 (95% CI 1.1 to 2.3) compared to reference levels (250-275 micromol/L).
  • Dose-response relationships varied by vascular bed: U-shaped for peripheral and cerebrovascular disease, weak positive for coronary heart disease.

Conclusions:

  • Plasma total cysteine (tCys) exhibits a significant U-shaped association with cardiovascular disease risk.
  • This relationship persists after adjusting for tHcy, creatinine, and other CVD risk factors.
  • The findings highlight tCys as a potential, independent marker for vascular disease risk.
Abstract

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