Hyperhomocysteinemia in West Virginians with documented atherosclerotic disease

Area of Science:

• Cardiovascular Medicine
• Clinical Biochemistry
• Nutritional Science

Background:

• Elevated plasma homocysteine is a risk factor for atherosclerotic disease.
• Previous studies indicated higher homocysteine levels in atherosclerotic populations.
• Limited data exists on homocysteine levels in specific geographic populations and the impact of comorbidities.

Purpose of the Study:

• To investigate plasma homocysteine levels in West Virginians with atherosclerotic disease.
• To identify factors correlating with elevated homocysteine.
• To evaluate the efficacy of folic acid supplementation in reducing homocysteine levels and assess the influence of serum creatinine and gender.

Main Methods:

• Cross-sectional study of 282 West Virginians with atherosclerotic disease.
• Correlation analysis of plasma homocysteine with age, gender, and serum creatinine.
• Intervention study involving 54 patients treated with 1 mg folic acid daily.
• Assessment of homocysteine reduction and impact of creatinine on treatment efficacy.

Main Results:

• Plasma homocysteine levels were lower than previously reported in similar populations.
• Homocysteine levels positively correlated with age and serum creatinine.
• A trend towards higher homocysteine in men was observed but not statistically significant.
• Folic acid (1 mg) reduced plasma homocysteine by 21% in both genders.
• Elevated creatinine levels reduced the efficacy of folic acid treatment.
• Three patients with homocysteine >100 mmol/L had B12 deficiency.

Conclusions:

• West Virginian atherosclerotic patients exhibit lower plasma homocysteine than expected.
• Age and serum creatinine are key correlates of elevated homocysteine.
• Folic acid is effective in lowering homocysteine, but its efficacy is impaired by elevated creatinine.
• Vitamin B12 deficiency should be considered in cases of severe hyperhomocysteinemia.