当前位置： SCI文献检索 > ATHEROSCLEROSIS期刊下所有文献 > Folate status is the major determinant of fasting total plasma homocysteine levels in maintenance dialysis patients.

Folate status is the major determinant of fasting total plasma homocysteine levels in maintenance dialysis patients.

Abstract：

:Limited data are available on the determinants of homocysteinemia or the association between plasma homocysteine (Hcy) levels and prevalent cardiovascular disease (CVD) in maintenance dialysis patients. We assessed etiology of renal failure, residual renal function and dialysis adequacy-related variables, and vitamin status, as determinants of fasting total plasma homocysteine (Hcy) in 75 maintenance dialysis patients. We also assessed the potential interactive effect on plasma Hcy of folate status and a common mutation (ala to val; homozygous val-val frequency approximately 10%) in methylenetetrahydrofolate reductase (MTHFR), a folate-dependent enzyme crucial for the remethylation of homocysteine (Hcy) to methionine. Lastly, we evaluated whether the Hcy levels differed amongst these patients in the presence or absence of prevalent CVD, after adjustment for the traditional CVD risk factors. Fasting total plasma Hcy, folate, pyridoxal 5'-phosphate (PLP; active B6), B12, creatinine, glucose, total and HDL cholesterol levels, and presence of the ala to val MTHFR mutation were determined, and clinical CVD and CVD risk factor prevalence were ascertained. General linear modelling/analysis of covariance revealed: (1) folate status and serum creatinine were the only significant independent predictors of fasting Hcy; (2) there was a significant interaction between presence of the val mutation and folate status, i.e., among patients with plasma folate below the median (< 29.2 ng/ml), geometric mean Hcy levels were 33% greater (29.0 vs. 21.8 microM, P = 0.012) in the pooled homozygotes (val-val) and heterozygotes (ala-val) for the ala to val mutation, vs. normals (ala-ala); (3) there was no association between prevalent CVD and plasma Hcy. Given potentially intractable survivorship effects, prospective cohort studies will be required to clarify the relationship between plasma Hcy or any putative CVD risk factor, and incident CVD in dialysis patients. If a positive association between plasma Hcy and incident CVD can be established in maintenance dialysis patients, the current data provide a rationale for additional folic acid supplementation in this patient population.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Bostom AG,Shemin D,Lapane KL,Nadeau MR,Sutherland P,Chan J,Rozen R,Yoburn D,Jacques PF,Selhub J,Rosenberg IH

doi

10.1016/0021-9150(96)05809-1

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

193-202

issue

1-2

eissn

0021-9150

issn

1879-1484

pii

0021-9150(96)05809-1

journal_volume

123

pub_type

杂志文章

在线工具

Folate status is the major determinant of fasting total plasma homocysteine levels in maintenance dialysis patients.