Ganji Vijay, Kafai Mohammad R
Division of Nutrition, School of Health Professions, College of Health and Human Sciences, Georgia State University, Atlanta, GA 30303, USA.
J Nutr. 2009 Feb;139(2):345-52. doi: 10.3945/jn.108.092726. Epub 2008 Dec 23.
Elevated circulating total homocysteine (tHcy) concentrations are related to increased risk for cardiovascular disease. Folic acid fortification resulted in a significant decrease in circulating tHcy in the United States. In the post-folic acid fortification period, associations between plasma tHcy and demographic, health, and lifestyle factors and B vitamin status were investigated. Data from the 3 recent NHANES cycles (1999-2004) were used to study the associations among plasma tHcy and sex, race/ethnicity, age, BMI, blood pressure (BP), serum creatinine, serum cotinine, vitamin/mineral supplement use, and folate and cobalamin status in 16,254 persons (8329 men, 7925 women). Multivariate-adjusted plasma tHcy was approximately 9.7% higher in men than in women (P < 0.0001), approximately 5.3% higher in non-Hispanic whites than in non-Hispanic blacks (P < 0.0001), approximately 64.5% higher in individuals aged >or=60 y than in individuals aged <20 y (P < 0.0001), and approximately 5% higher in supplement nonusers than in supplement users (P < 0.0001). Persons in the 4th quartile for serum creatinine, serum cotinine, systolic BP, and serum methylmalonic acid (MMA) had approximately 36.1, approximately 13.4, approximately 5.6, and approximately 16.2%, respectively, higher tHcy than those in the 1st quartile (P < 0.0001). Plasma tHcy was inversely associated with serum folate (P < 0.0001), RBC folate (P < 0.0001), and serum cobalamin (P < 0.0001). In the post-folic acid fortification period, sex, race/ethnicity, age, systolic BP, supplement use, RBC folate, and serum creatinine, cotinine, folate, and cobalamin are significant determinants of plasma tHcy. Serum MMA was strongly associated with plasma tHcy.
循环总同型半胱氨酸（tHcy）浓度升高与心血管疾病风险增加相关。在美国，叶酸强化导致循环tHcy显著降低。在叶酸强化后期，对血浆tHcy与人口统计学、健康和生活方式因素以及B族维生素状态之间的关联进行了调查。利用最近3个国家健康与营养检查调查（NHANES）周期（1999 - 2004年）的数据，研究了16254人（8329名男性，7925名女性）血浆tHcy与性别、种族/族裔、年龄、体重指数（BMI）、血压（BP）、血清肌酐、血清可替宁、维生素/矿物质补充剂使用情况以及叶酸和钴胺素状态之间的关联。多变量调整后男性的血浆tHcy比女性高约9.7%（P < 0.0001），非西班牙裔白人比非西班牙裔黑人高约5.3%（P < 0.0001），年龄≥60岁的个体比年龄<20岁的个体高约64.5%（P < 0.0001），不使用补充剂者比使用补充剂者高约5%（P < 0.0001）。血清肌酐、血清可替宁、收缩压和血清甲基丙二酸（MMA）处于第4四分位数的人群，其tHcy分别比处于第1四分位数的人群高约36.1%、约13.4%、约5.6%和约16.2%（P < 0.0001）。血浆tHcy与血清叶酸（P < 0.0001）、红细胞叶酸（P < 0.0001）和血清钴胺素（P < 0.0001）呈负相关。在叶酸强化后期，性别、种族/族裔、年龄、收缩压、补充剂使用情况、红细胞叶酸以及血清肌酐、可替宁、叶酸和钴胺素是血浆tHcy的重要决定因素。血清MMA与血浆tHcy密切相关。
