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Plasma homocysteine levels in patients with coronary heart disease
1Department of Cardiology, Sree Sudheendra Medical Mission, Cochin.
Insights
Hyperhomocysteinemia is not a significant risk factor for coronary heart disease in Asian Indians. Further research is needed to explore potential ethnic differences in homocysteine levels and heart disease risk.
Area of Science:
- Cardiology
- Metabolic Disorders
- Epidemiology
Background:
- Hyperhomocysteinemia is a known risk factor for coronary heart disease (CHD).
- Its prevalence and significance among Asian Indians remain understudied.
- Understanding this could inform public health strategies due to the condition's remediable nature.
Purpose of the Study:
- To investigate the association between hyperhomocysteinemia and coronary heart disease in an Asian Indian population.
- To determine if existing data from Western populations are applicable to Asian Indians.
Main Methods:
- A case-control study involving 56 CHD patients and 53 healthy controls.
- Exclusion of patients with renal and liver diseases.
- Serum homocysteine levels measured using liquid chromatography, with dietary, smoking, and medical history data collected.
Main Results:
- No statistically significant difference in homocysteine levels was observed between CHD patients (10.98 ± 9.04 nmol/ml) and controls (9.41 ± 3.60 nmol/ml).
- Subgroup analysis by sex and age did not reveal significant associations.
- A small percentage of both groups had homocysteine levels above the 95th percentile of controls.
Conclusions:
- Homocysteine does not appear to be a major risk factor for coronary heart disease in this Asian Indian cohort.
- The lack of statistical significance may be due to insufficient sample size.
- Larger studies are recommended to confirm findings and explore potential ethnic variations.
Abstract:
Hyperhomocysteinemia is being identified as a risk factor for coronary heart disease but its role among Asian Indians has not been studied. This has practical importance because (1) the data generated in the West may not represent Indian population, and (2) the condition is remediable. To assess the magnitude of this problem, we studied 56 patients with coronary heart disease, and 53 control subjects. Details of diet, smoking, medication, hypertension and diabetes were recorded; lipids and sugar levels were estimated in all. Patients with renal and liver diseases were excluded. Serum homocysteine was estimated using liquid chromatography. Both the groups were comparable by age and sex. Higher, but statistically insignificant homocysteine levels were seen in patients with coronary heart disease: 10.98 +/- 9.04 nmol/ml vs 9.41 +/- 3.60 nmol/ml in control subjects. Among males, higher, but statistically insignificant levels were seen in coronary heart disease patients: 11.96 +/- 9.41 nmol/ml vs 9.87 +/- 3.50 nmol/ ml in control subjects; among females, the levels were lower though not significant: 5.10 +/- 1.64 nmol/ml vs 6.39 +/- 2.99 nmol/ml. Sub-group analysis with age 40 as dividing point did not show significant difference. Six (10.7%) patients with coronary heart disease and three (5.7%) control subjects had homocysteine levels above 95th percentile of control subjects (p = NS). Twenty-three (41.1%) coronary heart disease patients and 19 (35.9%) control subjects had levels above 10 nmol/ml (p = NS). We conclude that homocysteine is not a major risk factor for coronary heart disease in the study population. The lack of statistical significance could be due to inadequate sample size although some past studies reporting statistically significant association between coronary heart disease and homocysteine involved similar or smaller number of subjects. Larger studies are warranted to see if ethnic differences also have any role.