Serum homocysteine in Indian adolescents

To assess serum homocysteine levels and its association with conventional risk factors for cardiovascular disease (CVD) in Indian adolescents.

This was a cross-sectional study conducted in tertiary care hospital in northern India in apparently healthy adolescents aged 10-19 yr. A pre-designed questionnaire was used to assess conventional risk factors. Serum homocysteine levels of > or = 12 micromol/L, serum triglycerides > or = 150 mg% and serum cholesterol > or = 200 mg% were taken as hyperhomocysteinemia, hypertriglyceridemia and hypercholesterolemia, respectively. Serum high-density lipoprotein (HDL) > or = 40 mg% was considered protective for CVD.

In 103 subjects, 36.87 % females, mean serum homocysteine level was 11.649 +/-0.416 micromol/L. Hyperhomocysteinemia was present in 46 (44.6%, 95% CI: 34.965-54.75) subjects. Dietary deficiency of vitamin B12 and folic acid, body mass index (BMI) > 84(th) percentile and altered lipid profile were associated with hyperhomocysteinemia on univariate analysis. After multivariate adjustment for BMI and vegetarian diet, low serum HDL (OR: 23.81, 95% CI: 2.86-200; p = 0.003) and serum hypertriglyceridemia (OR: 4.17, 95% CI: 1.51-13.51; p = 0.022) had independent association with hyperhomocysteinemia.

Since we have also found an association between hyperhomocysteinemia and low serum HDL levels and hypertriglyceridemia, which are conventional risk factors for CVD, interventional strategies are urgently needed among adolescents for prevention of CVD.