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Hyperhomocyst(e)inemia and hemostatic factors: the atherosclerosis risk in communities study.

TitleHyperhomocyst(e)inemia and hemostatic factors: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2002
AuthorsSchreiner PJ, Wu KK, M Malinow R, Stinson VL, Szklo M, Nieto JF, Heiss G
JournalAnn Epidemiol
Volume12
Issue4
Pagination228-36
Date Published2002 May
ISSN1047-2797
KeywordsAge Factors, Arteriosclerosis, Blood Coagulation Factors, Cardiovascular Diseases, Carotid Artery Diseases, Cross-Sectional Studies, Ethnic Groups, Female, Hemostasis, Homocysteine, Humans, Hyperhomocysteinemia, Male, Middle Aged, Sex Factors, Smoking, Ultrasonography
Abstract

PURPOSE: To determine whether homocyst(e)ine (H(e)) is related to hemostatic factors in a population-based sample without evidence of cardiovascular disease.

METHODS: A subsample of 660 participants--67 African-American women, 53 African-American men, 201 white women, and 339 white men--was selected from the Atherosclerosis Risk in Communities Study baseline cohort. This was based on carotid intimal-medial wall thickness above the 90th percentile or below the 75th percentile of the population distribution, assessed by B-mode ultrasonography. Unadjusted and multivariable-adjusted associations between fasting plasma H(e) and the hemostatic factors fibrinogen, factor VII:c, factor VIII:c, protein C antigen, hematocrit, platelet count, beta-thromboglobulin (beta-TG), tissue plasminogen activator (tPA), PAI-1, D-dimer, and lipoprotein[a] were examined.

RESULTS: Mean age-adjusted H(e) was positively, albeit weakly, correlated with beta-TG, tPA, hematocrit, D-dimer and PAI-1; inversely correlated with protein C; and was higher in smokers, men and African-Americans. In multivariable regression, beta-TG, tPA, and factor VII:c were positively associated with H(e), as well as age, black race, male sex, and current cigarette smoking.

CONCLUSIONS: These cross-sectional data for a biracial group of middle-aged individuals suggest that H(e) levels falling below values consistent with homocyst(e)inemia are associated with several prothrombotic factors after adjustment for sociodemographic factors. If H(e) change is antecedent to altered hemostasis, FDA-mandated fortification of grain products with folic acid for prevention of fetal neural tube defects may lead to both reduced plasma H(e) levels and improved hemostatic profiles.

DOI10.1016/s1047-2797(01)00311-8
Alternate JournalAnn Epidemiol
PubMed ID11988410
Grant ListN01-HC-55018 / HC / NHLBI NIH HHS / United States