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Total homocysteine and its predictors in Dutch children^1,2,3

¹ From the Departments of Pediatrics (IMvB, LA, DO-vE, and HJB), Endocrinology (MdH), Epidemiology and Biostatistics (MdH), Obstetrics and Gynecology (CMGT), and Chemical Endocrinology (CMGT), Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Background: Vitamin status, methylenentetrahydrofolate reductase (MTHFR) genotype, age, sex, and lifestyle factors are all predictors of total homocysteine (tHcy) concentrations in adults. Limited data are available about the influence of these factors on tHcy in children.

Objective: The objective was to describe tHcy and its predictors in Dutch children.

Design: A sample of 234 white children aged 0–19 y was analyzed cross-sectionally.

Results: The geometric mean tHcy concentrations were 5.1 (95% CI: 4.6, 5.6), 4.6 (4.2, 5.1), 6.2 (5.6, 6.9), 7.3 (6.7, 8.0), and 8.7 (7.9, 9.6) µmol/L in the 0–1, 2–5, 6–10, 11–14, and 15–19 y groups, respectively. Plasma folate and vitamin B-12 concentrations decreased markedly with age. The inverse association between tHcy and plasma folate seen at all ages was stronger than that between tHcy and plasma vitamin B-12. A negative association of plasma folate with tHcy was confined to folate concentrations <20 nmol/L. Homozygosity for the MTHFR 677CT polymorphism was identified in 8.2% of the children. The homocysteine concentration did not differ significantly between the MTHFR genotypes.

Conclusions: This study provided age-specific data regarding tHcy concentrations and their predictors in the whole range of childhood. The tHcy concentration increased as a function of age in both sexes. Plasma folate was a concentration-dependent predictor of tHcy. The MTHFR 677CT polymorphism played a minor role in determining tHcy concentrations in children.

Key Words: Children • creatinine • folate • total homocysteine • methylenetetrahydrofolate reductase • MTHFR • vitamin B-12

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