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American Journal of Clinical Nutrition, Vol. 70, No. 5, 937, November 1999
© 1999 American Society for Clinical Nutrition

Letters to the Editor

Serum folate and homocysteine concentrations in large population samples of US ethnic and racial groups

Joseph E Baggott

University of Alabama at Birmingham, Department of Nutrition Sciences, 336 Webb Building, 1675 University Boulevard, Birmingham, AL 35294-3360

Dear Sir:

Two papers, one reporting serum folate concentrations (1) and one reporting serum homocysteine concentrations (2) in large population samples of US ethnic and racial groups, appeared recently in the Journal. The largest difference in adjusted mean serum folate concentrations was between white (non-Hispanic) and Mexican American females (aged >=17 y): 18.4 compared with 15.9 nmol/L, respectively (1). The geometric mean serum homocysteine concentrations for samples of the above populations (aged >=12 y) were 7.9 and 7.4 µmol/L, respectively (2). The mean serum homocysteine value for Mexican American females was the lowest of the 6 sex and ethnic-racial sample means determined. Almost the same results are obtained if unadjusted means are compared or if only means from women aged 16 (or 17) to 49 y are compared. A qualitatively similar trend in the data is found when means from a sample of males from these 2 populations are compared. The trend for lower mean serum folate concentrations is apparently associated with the lower mean serum homocysteine concentrations.

The serum samples for these folate and homocysteine assays were collected from 1988 to 1991 and from 1991 to 1994, respectively. It is therefore difficult to conceive that large changes occurred in these populations during this relatively short time. The authors characterized their results as being "nationally representative results " (1) and "reference information . . . in a nationally representative sample" (2). Thus, one could conclude from the above that lower mean serum folate concentrations are associated with lower mean serum homocysteine concentrations when these 2 populations are compared. Yet this conclusion would be inconsistent with a body of literature reporting that relatively low serum folate concentrations (or low folate intakes) are strongly associated with relatively high serum homocysteine concentrations (3, 4). Perhaps other vitamins or nutrients or genetic factors completely reverse the powerful effect of folate nutriture on serum homocysteine concentrations in these populations.

REFERENCES

  1. Ford ES, Bowman BA. Serum and red blood cell folate concentrations, race, and education: findings from the third National Health and Nutrition Examination Survey. Am J Clin Nutr 1999;69:476–81.[Abstract/Free Full Text]
  2. Jacques PF, Rosenberg IH, Rogers G, et al. Serum total homocysteine concentrations in adolescent and adult Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr 1999;69:482–9.[Abstract/Free Full Text]
  3. Boushey CJ, Beresford SM, Omen GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA 1995; 274:1049–57.[Abstract]
  4. Refsum H, Ueland PM, Nygård O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med 1998;49:31–62.[Medline]




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