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Disorders of Lipid Metabolism

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.

Homocysteine, Folate, B-12: Overview Table
	Lindeman, 2003	Lee, 2003	Schnyder, 2002	Liem, 2003	Toole, 2004	Bautista, 2002	Hcyt Coll Study
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
Sex
% male	53	77	Intervention: 79 Placebo: 82	Intervention: 76 Control: 80	Low Dose: 62.8 High Dose: 62.3
% female	47	23	Intervention: 21 Placebo: 18	Intervention: 24 Control: 20	Low Dose: 37.2 High Dose: 37.7
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		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
Race	Hispanic vs non-white Hispanic	participants from Taiwan; ? Race for all			Low Dose: black 15.4%, white 78.4%, other 6.2% High Dose: black 14.2%, white 80.6%, other 5.2%
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
*Baseline Values*
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
LDL-C (mg/dL)		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
TG (mg/dL)		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
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
Homocysteine (umol/L)	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
Results (% change)	not an intervention study	not an intervention study
TC					Low Dose: 194.0 +/- 40.8 High Dose: 193.8 +/- 42.5
TG					Low Dose: 173.5 +/- 107.0 High Dose: 170.3 +/- 101.6
HDL					Low Dose: 47.8 +/- 15.0 High Dose: 49.2 +/- 16.7
Plasma folic Acid			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
Plasma Homocysteine			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
*Other Outcome*
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)