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Association between elevated plasma total homocysteine and increased common carotid artery wall thickness
S Voutilainen1, G Alfthan, K Nyyssönen
1Research Institute of Public Health, University of Kuopio, Finland.
Insights
Elevated total homocysteine (tHcy) levels are linked to early atherosclerosis in middle-aged men. This study found higher carotid artery wall thickness in men with high tHcy, indicating a potential risk factor for arterial disease.
Area of Science:
- Cardiovascular Disease Epidemiology
- Vascular Biology
- Biomarkers of Atherosclerosis
Background:
- Homocysteine is an emerging risk factor for atherothrombotic arterial diseases.
- Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis.
Purpose of the Study:
- To investigate the association between plasma total homocysteine (tHcy) concentrations and CIMT.
- To assess the relationship in asymptomatic individuals aged 45-69 in eastern Finland.
Main Methods:
- B-mode ultrasonography was used to measure common carotid artery intima-media wall thickness.
- Plasma tHcy levels were measured, and subjects were categorized by concentration (above or below 11.5 micromol/L).
- Data from 513 participants at the baseline of the ASAP study were analyzed.
Main Results:
- Adjusted mean CIMT was significantly higher in men with elevated plasma tHcy (1.12 mm) compared to those with lower levels (1.02 mm; P = 0.029).
- No significant association was found between plasma tHcy and CIMT in women.
- Prevalence of elevated tHcy was 33% in men and 18% in women.
Conclusions:
- Elevated plasma tHcy concentrations are associated with increased common carotid artery intima-media wall thickness in middle-aged eastern Finnish men.
- This suggests tHcy may be an early indicator of atherosclerosis in this population.
- Further research is warranted to explore gender-specific differences and interventions.
Abstract:
Homocysteine is increasingly recognized as a risk factor for atherothrombotic arterial diseases. We investigated the relation between plasma concentrations of total homocysteine (tHcy) and common carotid artery intima-media wall thickness, measured by B-mode ultrasonography, in 513 asymptomatic men and women from eastern Finland aged 45-69 years. The subjects were examined in 1994-95 at the baseline of the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study, a randomized double-blind placebo-controlled two by two factorial trial on the effect of vitamin E and C supplementation in the prevention of atherosclerotic progression. The subjects were assigned into two categories according to the plasma tHcy concentration; concentration over 11.5 micromol/L (highest quartile) or concentration below 11.5 micromol/L. In this study population the mean plasma tHcy concentration was 10.0 micromol/L, and the prevalence of plasma tHcy concentration exceeding 11.5 micromol/L was 33% in men and 18% in women. The adjusted mean intima-media thickness of the right and left common carotid arteries was 1.12 mm in men with elevated plasma tHcy concentration and 1.02 mm in men with a plasma tHcy concentration below 11.5 micromol/L (P = 0.029). In women there was no significant difference. We conclude that elevated plasma tHcy concentrations are associated with early atherosclerosis, as manifested by increased common carotid artery intima-media wall thickness, in middle-aged eastern Finnish men.