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Homocysteine, cardiovascular disease risk factors, and habitual diet in the French Supplementation with Antioxidant Vitamins and Minerals Study^1,2,3

¹ From the UMR INSERM unit 557/INRA unit 1125, Institut Scientifique et Technique de la Nutrition et de l’Alimentation, ISTNA (LIM, GPdC, SB, MM, MZ, CF, SH, and PG) and Unité de Surveillance et d’Epidémiologie Nutritionnelle, InVS (LIM and SH), Conservatoire National des Arts et Metiers, Paris; the Laboratoire de Physiologie, Faculté de Médecine, Dijon, France (J-CG); the Laboratoire de Laboratoire de Biologie du Stress Oxydant, Faculté de Pharmacie, Grenoble, France (VD and AF); and the Laboratoire de Biochimie Médicale et Pédiatrique, INSERM unit 308, Faculté de Médecine, Vandoeuvre-lès-Nancy, France (J-PN).

Background: An elevated plasma total homocysteine (tHcy) concentration seems to increase the risk of cardiovascular disease.

Objective: We evaluated the determinants of tHcy in healthy French adults.

Design: tHcy was measured by HPLC and fluorometric detection in 1139 women and 931 men aged 35–60 y. Subjects were participants of the Supplementation with Antioxidant Vitamins and Minerals Study, which investigates the effects of antioxidant supplementation on chronic diseases. Red blood cell folate (RBCF), plasma vitamins B-6 and B-12, and cardiovascular disease risk factors were also measured. The habitual diet was assessed in 616 subjects. Cross-sectional analyses were adjusted for age, smoking, energy intake, and concentration or intake of folate and vitamin B-6, where appropriate.

Results: The mean (±SD) tHcy concentration was 8.74 ± 2.71 µmol/L in women and 10.82 ± 3.49 µmol/L in men. In women, tHcy was positively related to age (P = 0.001), apolipoprotein B (P < 0.01), serum triacylglycerol (P < 0.01), fasting glucose (P = 0.02), and coffee and alcohol consumption (both P < 0.01) and inversely related to RBCF (P = 0.11) and plasma vitamin B-12 (P = 0.08) and vitamin B-6 (P = 0.01) intakes. In men, tHcy was positively associated with body mass index (P = 0.03), blood pressure (P < 0.02), serum triacylglycerol (P < 0.01), fasting glucose (P = 0.01), and energy intake (P < 0.01) and inversely associated with physical activity (P = 0.04), RCBF (P = 0.02), plasma vitamin B-12 (P = 0.09), and dietary fiber (P < 0.01), folate (P = 0.03), and vitamin B-6 (P = 0.09) intakes.

Conclusion: To control tHcy, decreasing coffee and alcohol consumption may be important in women, whereas increasing physical activity, dietary fiber, and folate intake may be important in men.

Key Words: Homocysteine • habitual diet • folate • cardiovascular disease risk • men • women • coffee • Supplementation with Antioxident Vitamins and Minerals Study • France

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