The Influence of Folates, B 12 Vitamin and LifeStyle Factors on MildHyperhomocyteinemia in a Population Sample

Overview

Background.
Mild hyperhomocysteinaemia (MHHcy) is a significant and independent risk factor for vasculardiseases, however, its causality has not yet been unequivocally confirmed. The total homocysteine (Hcy) blood levelis considered a product of genetic and lifestyle interactions, mainly folates, vitamin B 12 and pyridoxine intake. Inthis paper we estimated the influence of these factors on MHHcy in the population.Methods and Results. The population sample included 292 males a 251 women, mean age 53.4 years, selectedfrom the population study PILS II. All subjects were examined by a standard protocol for clinical, anthropometricaland laboratory examination. Hcy levels were examined by ion exchange chromatography, all other factors bycommercial kits. Statistical analysis was done in quartiles of distribution by Kruskal-Wallis ANOVA, Wilcoxon’sun-paired test and multiple logistic regression (stepwise).Serum total Hcy levels were in significant positive associations with age in both sexes, with BMI in males only.Negative associations of Hcy were found with plasma folates and B 12 concentrations in both sexes, with alcoholconsumption again only in males. Smoking and physical activity and serum methionine concentration were notassociated with Hcy levels. The established associations remained significant when adjusted by multiple logisticregression. About 40% of subjects with MHHcy had low folates and/or B 12 levels and a deficiency in both vitaminswas found in 17% of subjects. In contrast, MHHcy also was assessed in 14% of subjects with high folates and in17% with high B 12 concentration and in as few as in 3.7% of subjects with high concentrations of both vitamins aswell.Conclusions. Nutritional factors, i.e. folates and B 12 intake, seem to be the most important ones responsible forHcy levels. A predominating influence of genetic factors may be assumed in less than one fifth of subjects withMHHcy.

Key words:
homocysteine, folates, B 12 , alcohol intake, lifestyle, population.