Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Jan;54(1):31–34. doi: 10.1136/jech.54.1.31

Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore

K Hughes 1, C Ong 1
PMCID: PMC1731535  PMID: 10692959

Abstract

OBJECTIVE—To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly attributable to differences in blood concentrations of homocysteine, and related blood concentrations of folate and vitamin B12.
DESIGN—Cross sectional study of the general population.
SETTING—Singapore.
PARTICIPANTS—Random sample of 726 fasting subjects aged 30 to 69 years.
MAIN RESULTS—Mean plasma total homocysteine concentrations did not show significant ethnic differences; values were Indians (men 16.2 and women 11.5 µmol/l), Malays (men 15.0 and women 12.5 µmol/l), and Chinese (men 15.3 and women 12.2 µmol/l). Similarly, the proportions with high plasma homocysteine (>14.0 µmol/l) showed no important ethnic differences being, Indians (men 60.0 and women 21.9 %), Malays (men 53.9 and women 37.8 %), and Chinese (men 56.6 and women 30.6 %). Mean plasma folate concentrations were lower in Indians (men 8.7 and women 10.9 nmol/l) and Malays (men 8.5 and women 10.8 nmol/l), than Chinese (men 9.7 and women 13.8 nmol/l). Similarly, the proportions with low plasma folate (<6.8 nmol/l) were higher in Indians (men 44.9 and women 36.6 %) and Malays (men 45.3 and women 24.5 %) than Chinese (men 31.4 and women 12.6 %). Mean plasma vitamin B12 concentrations were lowest in Indians (men 352.5 and women 350.7 pmol/l), then Chinese (men 371.1 and women 373.7 pmol/l), and then Malays (men 430.5 and women 486.0 pmol/l).
CONCLUSION—While there were ethnic differences for plasma folate and vitamin B12 (in particular lower levels in Indians), there was no evidence that homocysteine plays any part in the differential ethnic risk from CHD in Singapore and in particular the increased susceptibility of Indians to the disease.


Keywords: coronary heart disease; ethnic; homocysteine

Full Text

The Full Text of this article is available as a PDF (76.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blount B. C., Mack M. M., Wehr C. M., MacGregor J. T., Hiatt R. A., Wang G., Wickramasinghe S. N., Everson R. B., Ames B. N. Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage. Proc Natl Acad Sci U S A. 1997 Apr 1;94(7):3290–3295. doi: 10.1073/pnas.94.7.3290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Boushey C. J., Beresford S. A., Omenn G. S., Motulsky A. G. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049–1057. doi: 10.1001/jama.1995.03530130055028. [DOI] [PubMed] [Google Scholar]
  3. Fenech M., Aitken C., Rinaldi J. Folate, vitamin B12, homocysteine status and DNA damage in young Australian adults. Carcinogenesis. 1998 Jul;19(7):1163–1171. doi: 10.1093/carcin/19.7.1163. [DOI] [PubMed] [Google Scholar]
  4. Ford E. S., Byers T. E., Giles W. H. Serum folate and chronic disease risk: findings from a cohort of United States adults. Int J Epidemiol. 1998 Aug;27(4):592–598. doi: 10.1093/ije/27.4.592. [DOI] [PubMed] [Google Scholar]
  5. Hughes K., Aw T. C., Kuperan P., Choo M. Central obesity, insulin resistance, syndrome X, lipoprotein(a), and cardiovascular risk in Indians, Malays, and Chinese in Singapore. J Epidemiol Community Health. 1997 Aug;51(4):394–399. doi: 10.1136/jech.51.4.394. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hughes K., Lun K. C., Yeo P. P. Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. I. Differences in mortality. J Epidemiol Community Health. 1990 Mar;44(1):24–28. doi: 10.1136/jech.44.1.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hughes K., Ong C. N. Vitamins, selenium, iron, and coronary heart disease risk in Indians, Malays, and Chinese in Singapore. J Epidemiol Community Health. 1998 Mar;52(3):181–185. doi: 10.1136/jech.52.3.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hughes K., Yeo P. P., Lun K. C., Thai A. C., Sothy S. P., Wang K. W., Cheah J. S., Phoon W. O., Lim P. Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. II. Differences in risk factor levels. J Epidemiol Community Health. 1990 Mar;44(1):29–35. doi: 10.1136/jech.44.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McKeigue P. M. Coronary heart disease in Indians, Pakistanis, and Bangladeshis: aetiology and possibilities for prevention. Br Heart J. 1992 May;67(5):341–342. doi: 10.1136/hrt.67.5.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Michie C. A., Chambers J., Abramsky L., Kooner J. S. Folate deficiency, neural tube defects, and cardiac disease in UK Indians and Pakistanis. Lancet. 1998 Apr 11;351(9109):1105–1105. doi: 10.1016/s0140-6736(05)79386-7. [DOI] [PubMed] [Google Scholar]
  11. Miner S. E., Evrovski J., Cole D. E. Clinical chemistry and molecular biology of homocysteine metabolism: an update. Clin Biochem. 1997 Apr;30(3):189–201. doi: 10.1016/s0009-9120(96)00172-5. [DOI] [PubMed] [Google Scholar]
  12. Motti C., Gnasso A., Bernardini S., Massoud R., Pastore A., Rampa P., Federici G., Cortese C. Common mutation in methylenetetrahydrofolate reductase. Correlation with homocysteine and other risk factors for vascular disease. Atherosclerosis. 1998 Aug;139(2):377–383. doi: 10.1016/s0021-9150(98)00079-3. [DOI] [PubMed] [Google Scholar]
  13. Obeid O. A., Mannan N., Perry G., Iles R. A., Boucher B. J. Homocysteine and folate in healthy east London Bangladeshis. Lancet. 1998 Dec 5;352(9143):1829–1830. doi: 10.1016/s0140-6736(05)79892-5. [DOI] [PubMed] [Google Scholar]
  14. Selhub J., Jacques P. F., Wilson P. W., Rush D., Rosenberg I. H. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA. 1993 Dec 8;270(22):2693–2698. doi: 10.1001/jama.1993.03510220049033. [DOI] [PubMed] [Google Scholar]
  15. Smolin L. A., Schneider J. A. Measurement of total plasma cysteamine using high-performance liquid chromatography with electrochemical detection. Anal Biochem. 1988 Feb 1;168(2):374–379. doi: 10.1016/0003-2697(88)90332-6. [DOI] [PubMed] [Google Scholar]
  16. Welch G. N., Loscalzo J. Homocysteine and atherothrombosis. N Engl J Med. 1998 Apr 9;338(15):1042–1050. doi: 10.1056/NEJM199804093381507. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES