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. 2014 Jul;235(1):94-101.
doi: 10.1016/j.atherosclerosis.2014.04.010. Epub 2014 Apr 28.

Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease

Monica L Bertoia  1 , Jennifer K Pai  2 , John P Cooke  3 , Michel M Joosten  4 , Murray A Mittleman  5 , Eric B Rimm  6 , Kenneth J Mukamal  7
Affiliations

Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease

Monica L Bertoia et al. Atherosclerosis. 2014 Jul.

Abstract

Objective: Few studies have examined the roles of homocysteine and related nutrients in the development of peripheral artery disease (PAD). We examined the associations between plasma homocysteine, dietary B vitamins, betaine, choline, and supplemental folic acid use and incidence of PAD.

Methods: We used two cohort studies of 72,348 women in the Nurses' Health Study (NHS, 1990-2010) and 44,504 men in the Health Professionals Follow-up Study (HPFS, 1986-2010). We measured plasma homocysteine in nested matched case-control studies of clinically recognized PAD within both cohorts, including 143 PAD cases and 424 controls within the NHS (1990-2010) and 143 PAD cases and 428 controls within the HPFS (1994-2008). We examined the association between diet and risk of incident PAD in the cohorts using a food frequency questionnaire and 790 cases of PAD over 3.1 million person-years of follow-up.

Results: Higher homocysteine levels were positively associated with risk of PAD in men (adjusted IRR 2.17; 95% CI, 1.08-4.38 for tertile 3 vs. 1). There was no evidence of an association in women (adjusted IRR 1.14; 95% CI, 0.61-2.12). Similarly, higher folate intake, including supplements, was inversely associated with risk of PAD in men (adjusted HR 0.90; 95% CI, 0.82-0.98 for each 250 μg increase) but not women (HR 1.01, 95% CI, 0.88-1.15). Intakes of the other B vitamins, betaine, and choline were not consistently associated with risk of PAD in men or women.

Conclusion: Homocysteine levels were positively associated and dietary folate intake was inversely associated with risk of PAD in men but not in women.

Keywords: Betaine; Choline; Folate; Homocysteine; Peripheral artery disease; Riboflavin; Vitamin B12; Vitamin B6.

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References

    1. Splaver A, Lamas GA, Hennekens CH. Homocysteine and cardiovascular disease: biological mechanisms, observational epidemiology, and the need for randomized trials. Am Heart J. 2004 Jul;148(1):34–40. - PubMed
    1. Criqui MH. Peripheral arterial disease--epidemiological aspects. Vasc Med. 2001;6(3 Suppl):3–7. - PubMed
    1. Strain JJ, Dowey L, Ward M, Pentieva K, McNulty H. B-vitamins, homocysteine metabolism and CVD. Proc Nutr Soc. 2004 Nov;63(4):597–603. - PubMed
    1. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049–1057. - PubMed
    1. Clarke R, Halsey J, Lewington S, et al. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med. 2010 Oct 11;170(18):1622–1631. - PubMed

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