DLM: Homocysteine, Folate, B-12 Overview Table (2007)
Homocysteine, Folate, B-12 Overview Table
For a quck comparason of the research we reviewed on homocysteine, folate, and vitamin B, please see the Overview Table.
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Lindeman, 2003 |
Lee, 2003 |
Schnyder, 2002 |
Liem, 2003 |
Toole, 2004 |
Bautista, 2002 |
Hcyt Coll Study |
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Sample size |
n=791 420 men 371 women |
60 with CAD 60 references |
Hcyt therapy group: 272 Placebo group: 281 |
Folic acid group: 300 Control group: 293 |
High dose vitamin group: 1853 Low dose vitamin group: 1827 |
14 cohort studies data from 2529 cases and 7305 non-cases |
data from 30 studies 5073 IHD events |
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Sex |
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% male |
53 |
77 |
Intervention: 79 Placebo: 82 |
Intervention: 76 Control: 80 |
Low Dose: 62.8 High Dose: 62.3 |
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% female |
47 |
23 |
Intervention: 21 Placebo: 18 |
Intervention: 24 Control: 20 |
Low Dose: 37.2 High Dose: 37.7 |
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Mean BMI |
quartile 1: 25.8 + 3.6 quartile 2: 25.3 + 3.8 quartile 3: 26.2 + 3.6 quartile 4: 26.1 + 4.1 |
CAD group: 25.7 +/- 2.7 Reference group: 24.8 +/- 3.7 |
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Folic acid: 26.7 +/- 3.4 Control: 27.3 +/- 3.6 |
Low Dose: 28.1 +/- 5.3 men; 28.5 +/- 5.9 women High Dose: 28.1 +/- 5.3 men; 28.7 +/- 6.7 women |
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Race |
Hispanic vs non-white Hispanic |
participants from Taiwan; ? Race for all |
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Low Dose:
High Dose:
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Mean age (yrs) |
Men: quartile 1:73 +/- 5.3 quartile 2: 73 +/- 5.6 quartile 3: 74.6 +/- 6 quartile 4: 75 +/- 6.9 Women quartile 1: 72.5 +/- 5.3 quartile 2: 73.4 +/- 5.7 quartile 3: 73.7 +/- 6.8 quartile 4: 75.8 +/- 6.5 |
CAD group: 71.6 +/- 9.7 Reference group: 65.5 +/- 9.0 |
Intervention: 63.4 +/- 10.6 Placebo: 61.8 +/- 11 |
Folic acid: 64.9 +/- 9.9 Control: 65.5 +/- 9.7 |
Low Dose: 66.2 +/- 10.8 High Dose: 66.4 +/- 10.8 |
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Baseline Values |
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TC (mg/dL) |
Men: quartile 1: 198.9 + 41.2, quartile 2: 199.2 + 33.5, quartile 3: 199.9 + 42.8, quartile 4: 189.1 + 46.7 Women: quartile 1: 224.6 + 43.4, quartile 2: 220.6 + 36.5, quartile 3: 214.3 + 39.3, quartile 4: 219.8 + 42.0 |
CAD group: 201.8 +/- 40.2 Reference group: 173.4 +/- 36.6 |
Intervention: 214 +/- 43 Placebo: 212 +/- 46 placebo |
Folic acid: 4.7 +/- 0.8 mmol/L Control: 4.5 +/- 0.7 mmol/L |
Low Dose: 203.0 +/- 46.5 High Dose: 200.8 +/- 46.9 |
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LDL-C (mg/dL) |
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CAD group: 127.5 +/- 35.7 Reference group: 112 +/- 30.1 |
Intervention: 130 +/- 37 Placebo: 130 +/- 40 placebo |
Folic acid: 2.7 +/- mmol/L Control: 2.6 +/- 0.6 mmol/L |
Low Dose: 123.3 +/- 40.1 High Dose: 121.6 +/- 40.2 |
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TG (mg/dL) |
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CAD group: 138.2 +/- 76.9 Reference group: 87.2 +/- 43.9 |
Intervention: 181 +/- 113 Placebo: 178 +/- 113 placebo |
Folic acid: 1.8 +/- 0.91 mmol/L Control: 1.8 +/- 0.96 mmol/L |
Low Dose: 172.7 +/- 108.7 High Dose: 176.8 +/- 190.1 |
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HDL-C (mg/dL) |
Men: quartile 1: 44 + 13.6, quartile 2: 43.2 + 12.1, quartile 3: 42.1 + 10.8, quartile 4: 44.7 + 16.8 Women: quartile 1: 54.8 + 14.5, quartile 2: 51.6 + 13.7, quartile 3: 55.3 + 14.9, quartile 4: 50.5 + 14 |
CAD group: 47.3 +/- 11.5 Reference group: 49.1 +/- 15.1 |
Intervention: 46 +/- 13 Placebo: 45 +/- 13 placebo |
Folic acid: 1.12 +/- 0.33 mmol/L Control: 1.14 +/- 0.30 mmol/L |
Low Dose: 45.6 +/- 15.7 High Dose: 45.2 +/- 15.3 |
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Homocysteine (umol/L)
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Men: quartile 1: 9.9 +/- 1.2 quartile 2: 12.2 +/- 0.5 quartile 3: 15.2 +/- 1.2 quartile 4: 23.2 +/- 11.3 Women: quartile 1: 8.6 +/- 0.9 quartile 2: 10.8 +/- 0.7 quartile 3: 13.4 +/- 0.9 quartile 4: 19.1 +/- 6.6 |
CAD group: 13.9 +/- 4.9 Reference group: 9.1 +/- 3.3 (p<0.001) |
Intervention: 11.4 +/- 4.73 Placebo: 11.1 +/- 4.59 placebo |
Folic acid: 12.0 +/- 4.8 umol/L Control: 12.2 +/- 3.8 umol/L |
greater than 25th percentile for North American stroke population in both groups (8.5 for women and 9.5 for men) mean: 13.4 umol both groups |
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Results (% change) |
not an intervention study |
not an intervention study |
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TC |
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Low Dose: 194.0 +/- 40.8 High Dose: 193.8 +/- 42.5 |
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TG |
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Low Dose: 173.5 +/- 107.0 High Dose: 170.3 +/- 101.6 |
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HDL |
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Low Dose: 47.8 +/- 15.0 High Dose: 49.2 +/- 16.7 |
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Plasma folic Acid |
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no data available |
increase about 16 nmol/L in folic acid 33 +/- 6 nmol/L folic acid |
no real data presented: graph shows that high dose had sig higher folate, but no real change in low dose |
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Plasma Homocysteine |
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decrease in homocystein: 6 month f/u: 7.5 +/- 2.51 intervention 10.1 +/- 4.22 in placebo |
decrease 18% in folic acid group 9.4 +/- 3.5 umol/L folic acid |
decrease was largest in high dose group about 2.0 decrease about 0.3 in low dose group |
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Other Outcome |
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Coronary events (% reduction) Association between Hcyt and prevalence of CAD |
Sig findings only Continuous variable (per one unit in umol/L) women 3.52 (1.16-7.22) Hispanic women 4.61 (1.16-18.4) Dichotomous variable (>/=15 vs <15 umol/L) women 2.99 (1.59-5.62) Hispanic women 4.3 (1.74-10.6) |
CAD group had significantly higher plasma Hcyt concentrations than reference group |
third cholesterol tertile in intervention group (> 228) had largest risk reduction in terms of target revascularization R = 0.44 (0.21-0.92) nonsignificant trend to decrease incident of nonfatal MI (RR=0.60 (0.24-1.51), p=0.22), cardiac deaths (RR=0.52 (0.13-2.04) p=0.34), and overall deaths (RR=0.54 (0.16-1.7), p=0.27) in intervention |
treatment with folic acid did not result in lowering recurrence of cardiovascular events |
no treatment effect between baseline Hcyt and CVD in follow up high dose vitamin group had no effect on the outcome of stroke, CHD events, or death |
increments in plasma Hcyt results in significant increase in risk for CVD (ARR=1.33 (1.21-1.47), p=0.004) increase in coronary heart disease (ARR=1.49 (1.31-1.70, p=0.006) |
25% lower usual Hcyt (~3umol/L) results in 11% lower IHD risk (OR=0.89 (0.83-0.96) and 19% lower stroke risk (OR=0.81 (0.69-0.95) |