Skip to main content
Indian Journal of Clinical Biochemistry logoLink to Indian Journal of Clinical Biochemistry
. 2006 Mar;21(1):95–100. doi: 10.1007/BF02913073

Raised serum homocysteine levels in patients of coronary artery disease and the effect of vitamin B12 and folate on its concentration

R Abraham 1,, M Joseph John 3, R Calton 4, J Dhanoa 3
PMCID: PMC3453787  PMID: 23105576

Abstract

Homocysteine(Hcy) has been implicated as a novel risk factor of Coronary Artery Disease (CAD) among Asian Indians, but many studies done in India failed to reveal any direct correlation. It has also been reported that Folic acid and Vitamin B12 levels inversely affect serum levels of homocysteine. In this study, we looked at the levels of homocysteine among patients with CAD. The effect of Vitamin B12, Folate and other risk factors on homocysteine levels were also evaluated. Mean homocysteine levels in cases (22.81±13.9, n=70) were significantly higher (p=<0.001) than the controls (7.77±7.3, n=70). However no statistically significant correlation could be deduced between homocysteine Vitamin B12, and Folate. Cumulative analysis have indicated an increase in homocysteine levels among patients with CAD with every additional risk factor.

Key words: Homocysteine, Coronary Artery Disease

Full Text

The Full Text of this article is available as a PDF (68.3 KB).

References

  • 1.Setti K.K., Mantri R.R. Homocysteine —Emerging evidences as an independent risk factor for CAD. Cardiology Today. 1999;3:122–129. [Google Scholar]
  • 2.Scott J.M., Weir D.G. Folic Acid, Homocysteine and one carbon metabolism: A review of the essential Biochemistry. J Cardiovascular Risk. 1998;5:223–227. doi: 10.1097/00043798-199808000-00003. [DOI] [PubMed] [Google Scholar]
  • 3.Stampfer M.J., Malinow M.R., Wilet W.C., et al. A prospective study of plasma homocysteine and risk of myocardial infarction in United States physicians. JAMA. 1992;268:877–881. doi: 10.1001/jama.268.7.877. [DOI] [PubMed] [Google Scholar]
  • 4.Wayne H.G., Janet B., Greenlund K., et al. Association between total homocysteine and the likelihood for a history of acute myocardial infarction by race and ethnicity. Am. Heart. J. 2000;139:446–453. doi: 10.1016/S0002-8703(00)90088-7. [DOI] [PubMed] [Google Scholar]
  • 5.Sehlub J., Jacques P.F., Bosten A.G., et al. Association between plasma homocysteine concentration and extracranial carotiod artery stenosis. N. Engl. J. Med. 1995;332:286–291. doi: 10.1056/NEJM199502023320502. [DOI] [PubMed] [Google Scholar]
  • 6.Perry J., Refsum H., Morris R.W., Ebrahim S.B., et al. Prospective study of serum total homocysteine concentration and risk of stroke in middle aged British men. Lancet. 1995;346:1395–1398. doi: 10.1016/S0140-6736(95)92407-8. [DOI] [PubMed] [Google Scholar]
  • 7.Den M., Henk T.K., Bos G.M., et al. Hyperhomocysteinaemia as a risk factor for deep vein thrombosis. N. Engl. J. Med. 1996;334:759–762. doi: 10.1056/NEJM199603213341203. [DOI] [PubMed] [Google Scholar]
  • 8.Harker L.A., Sherril J., Ronald C., Ross R. Homocysteinaemia, Vascular injury and arterial thrombosis. N. Engl. J. Med. 1974;291:537–543. doi: 10.1056/NEJM197409122911101. [DOI] [PubMed] [Google Scholar]
  • 9.Brattstrom E., Lindgren A., Israilsson B., Andersson A., Hultberg B. Homocysteine ans cysteine: determinants of plasma levels in middle aged and elderly subjects. J. Intern. Med. 1994;236:633–641. doi: 10.1111/j.1365-2796.1994.tb00856.x. [DOI] [PubMed] [Google Scholar]
  • 10.Malinow A. Homocysteine and arterial occulusive diseases. J. Internal. Med. 1994;236:603–617. doi: 10.1111/j.1365-2796.1994.tb00854.x. [DOI] [PubMed] [Google Scholar]
  • 11.Nygard O., Volloset S.E., Refsum H., Stenvoald I., Tverdal A., Nordrehaug J.E., et al. Plasma homocysteine levels and mortality in patients with coronary artery diseases. N. Eng. J. Med. 1997;337:230–236. doi: 10.1056/NEJM199707243370403. [DOI] [PubMed] [Google Scholar]
  • 12.Chambers J.C., Obeid O.A., Refsum H., Ueland P., Hacket D., Hooper J., Turner R.M., Thompson S.G., Kooner J.S. Plasma Homocysteine concentrations and risk of coronary heart disease in UK India Asian and European men. Lancet. 2000;160:422–434. doi: 10.1016/S0140-6736(99)93019-2. [DOI] [PubMed] [Google Scholar]
  • 13.Chacko K.A. Plasma homocysteine levels in patients with coronary artery disease. Indian Heart J. 1998;50:295–299. [PubMed] [Google Scholar]
  • 14.Gheye S., Lakshmi, Krishna T.P., et al. Fibrinogen and Homocysteine levels in coronary artery diseases. Indian Heart J. 1999;51:499–502. [PubMed] [Google Scholar]
  • 15.Gersh B.J., Braunwald E., Rutherford J.D. Chronic Coronary Artery Disease. In: Braunwald E., editor. Heart Disease—Textbook of Cardiovascular Medicine. 5th ed. Philadelphia: Saunder, W.B.; 1977. pp. 1331–1340. [Google Scholar]
  • 16.Homocysteine by Enzyme Immunoassay. BIORAD-(Company Manual) 1997.
  • 17.Cully K.S. Vascular pathology of homocysteine: Implications for the pathogenesis of arteriosclerosis. Am. J. Pathol. 1969;56:111–128. [PMC free article] [PubMed] [Google Scholar]
  • 18.Wilken D.E.L., Wilken B. Pathogenesis of coronary artery disease. A possible role for methionine metabolism. J. Clin. Invest. 1976;57:1079–1082. doi: 10.1172/JCI108350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Deepa R., Velmurugan K., Sarvanan G., Karkuzhah, Diwakanath V., Mohan V. Absence of association between serum homocysteine levels and coronary artery disease in South Indian males. Indian Heart J. 2001;53:44–47. [PubMed] [Google Scholar]
  • 20.Misra A., Vikram N.K., Pandey R.M., Dwivedi M., Ahmad F.U., Luthra K., Jain K., Khanna N., Devi J.R., Sharna R., Guleria R. Hyperhomocysteinaemia, and low intakes of folic acid and vitamin B12 in urban North India. Eur. J. Nutr. 2002;41(2):68–77. doi: 10.1007/s003940200010. [DOI] [PubMed] [Google Scholar]
  • 21.Hermann W., Schorr H., Purschwitz K., Rassoul F., Richter V. Total Homocysteine, Vitamin B12 and total anti oxidants status in vegetarians. Clinical Chem. 2001;47(6):1094–1101. [PubMed] [Google Scholar]
  • 22.Ortega R.M., Jemenez A., Andres P., Faci M., Lollo J.M., Lozano M.C., Bermejo L.M., Lopez-Sobaler A.M., Requejo A.M. Homocysteine levels in elderly Spanish people: Influence of pyridoxine, Vitamin B12 and folic acid intakes. J. Nutr. Health Ageing. 2002;6(1):69–71. [PubMed] [Google Scholar]
  • 23.Pancharunti L., Lewis C.A., Sauberlich H.E., Perkins L.L., Go P.C.P., Alwarez J.O. Plasma homocysteine, folate and Vitamin B12 concentrations and risk of early onset coronary artery disease. Am. J. Clin. Nutr. 1994;59:940–948. doi: 10.1093/ajcn/59.4.940. [DOI] [PubMed] [Google Scholar]
  • 24.Krishnaswamy K., Lakshmi A.V. Role of Nutritional supplementation in reducing the levels of homocysteine. J. Assoc. Physicians India. 2002;50:36–42. [PubMed] [Google Scholar]
  • 25.Mathews J.H., Wood J.K. Megaloblastic anemia in vegetarian Asians. Clin. Lab. Haematol. 1984;6:1–7. doi: 10.1111/j.1365-2257.1984.tb00519.x. [DOI] [PubMed] [Google Scholar]
  • 26.Dawson D.W., Waters H.M. Malnutrition, folate and cobalamine deficiency. Br. J. Biomed. 1994;51:221–227. [PubMed] [Google Scholar]
  • 27.Yeolkar M.E., Shete M.M. Homocysteine and hypertension. J. Assoc. Physicians India. 2002;50:29–35. [PubMed] [Google Scholar]
  • 28.Wall R.T., Harlan J.M., Haeber L.A., Striker G.E. Homocysteine induced endothelial cel injury in vivo: A model for the study of vascular injury. Thrombo Res. 1980;18:113–121. doi: 10.1016/0049-3848(80)90175-9. [DOI] [PubMed] [Google Scholar]
  • 29.Munshi M.N., Stone A., Fink L., Fonseca V. Hyperhomocysteinaemia following a methionine load in patients with non-insulin dependent diabetes mellitus and macrovascular disease. Metabolism. 1996;45:133–135. doi: 10.1016/S0026-0495(96)90211-5. [DOI] [PubMed] [Google Scholar]
  • 30.Hoffman M.A., Kohl B., Zumbach M.S., Borcea V.J., Bierhaus A., Henkels M., et al. Hyperhomocysteinaemia and endothelial dysfunction in IDDM. Diabetes Care. 1997;20:1880–1886. doi: 10.2337/diacare.20.12.1880. [DOI] [PubMed] [Google Scholar]

Articles from Indian Journal of Clinical Biochemistry are provided here courtesy of Springer

RESOURCES