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"Homocysteine"

Review Article

Serum Homocysteine and Vascular Calcification: Advances in Mechanisms, Related Diseases, and Nutrition
Susie Jung, Beom-Hee Choi, Nam-Seok Joo
Korean J Fam Med 2022;43(5):277-289.   Published online September 20, 2022
DOI: https://doi.org/10.4082/kjfm.21.0227
Identifying and preventing modifiable risk factors for cardiovascular disease is very important. Vascular calcification has been studied clinically as an asymptomatic preclinical marker of atherosclerosis and a risk factor for cardio-cerebrovascular disease. It is known that higher homocysteine levels are associated with calcified plaques and the higher the homocysteine level, the higher the prevalence and progression of vascular calcification. Homocysteine is a byproduct of methionine metabolism and is generally maintained at a physiological level. Moreover, it may increase if the patient has a genetic deficiency of metabolic enzymes, nutritional deficiencies of related cofactors (vitamins), chronic diseases, or a poor lifestyle. Homocysteine is an oxidative stress factor that can lead to calcified plaques and trigger vascular inflammation. Hyperhomocysteinemia causes endothelial dysfunction, transdifferentiation of vascular smooth muscle cells, and the induction of apoptosis. As a result of transdifferentiation and cell apoptosis, hydroxyapatite accumulates in the walls of blood vessels. Several studies have reported on the mechanisms of multiple cellular signaling pathways that cause inflammation and calcification in blood vessels. Therefore, in this review, we take a closer look at understanding the clinical consequences of hyperhomocysteinemia and apply clinical approaches to reduce its prevalence.

Citations

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  • Methionine synthetase A2756G and Cystathionine-β-synthase 844ins68 polymorphisms and coronary artery disease: A meta-analysis
    Yan-yan Li, Hui Wang, Yang-yang Zhang
    The American Journal of the Medical Sciences.2025; 369(5): 574.     CrossRef
  • Blood metabolites mediate causal inference studies on the effect of gut microbiota on the risk of vascular calcification
    Aoran Huang, Jianshuai Ma, Huijin Zhu, Yanli Qi, Yang Jin, Mingxuan Zhang, Li Yin, Minhong Luo, Sifan Chen, Chen Xie, Hui Huang
    Journal of Advanced Research.2025;[Epub]     CrossRef
  • Decoding post-myocardial infarction coronary microvascular dysfunction: The SP1-driven STAT3/KCa3.1/eNOS protective mechanism
    Zhen Wang, Yong Wang, Yan Cheng, Jingwen Zhang, Wenyang Nie, Xueqiang Liu, Hualiang Deng
    Cytojournal.2025; 22: 66.     CrossRef
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • Plasma Homocysteine Levels as Cardiovascular Disease Risk vis-a-vis Estrogen Levels in Pre and Postmenopausal Women
    Likhitha Munnangi, K. S. S. Sai Baba, Noorjahan Mohammed, Oruganti Sai Satish, M. Vijaya Bhaskar, Siraj Ahmed Khan, N. N. Sreedevi, Bhavya Sirivelu
    Indian Journal of Cardiovascular Disease in Women.2024; 9: 143.     CrossRef
  • Impact of Hyperhomocysteinemia on Cytokine and Matrix Metalloproteinases Contents in Rat Skeletal Muscle
    Olha Kravchenko, Raksha Nataliia, Kostiuk Oleksandra, Liashevska Oleksandra, Tiron Oksana, Maievskyi Oleksandr
    Biomedical and Biotechnology Research Journal.2024; 8(3): 387.     CrossRef
  • Vitamin K and age-related diseases
    K. A. Eruslanova, Yu. S. Onuchina, E. V. Ivannikova, E. N. Dudinskaya
    Russian Journal of Geriatric Medicine.2023; (4): 236.     CrossRef
  • 5,092 View
  • 108 Download
  • 3 Web of Science
  • 7 Crossref
Original Articles
Sex Difference in the Association between Serum Homocysteine Level and Non-Alcoholic Fatty Liver Disease
Bo-Youn Won, Kyung-Chae Park, Soo-Hyun Lee, Sung-Hwan Yun, Moon-Jong Kim, Kye-Seon Park, Young-Sang Kim, Ji-Hee Haam, Hyung-Yuk Kim, Hye-Jung Kim, Ki-Hyun Park
Korean J Fam Med 2016;37(4):242-247.   Published online July 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.4.242
Background

The relationship between serum homocysteine levels and non-alcoholic fatty liver disease is poorly understood. This study aims to investigate the sex-specific relationship between serum homocysteine level and non-alcoholic fatty liver disease in the Korean population.

Methods

This cross-sectional study included 150 men and 132 women who participated in medical examination programs in Korea from January 2014 to December 2014. Patients were screened for fatty liver by abdominal ultrasound and patient blood samples were collected to measure homocysteine levels. Patients that consumed more than 20 grams of alcohol per day were excluded from this study.

Results

The homocysteine level (11.56 vs. 8.05 nmol/L) and the proportion of non-alcoholic fatty liver disease (60.7% vs. 19.7%) were significantly higher in men than in women. In men, elevated serum homocysteine levels were associated with a greater prevalence of non-alcoholic fatty liver disease (quartile 1, 43.6%; quartile 4, 80.6%; P=0.01); however, in females, there was no significant association between serum homocysteine levels and the prevalence of non-alcoholic fatty liver disease. In the logistic regression model adjusted for age and potential confounding parameters, the odds ratio for men was significantly higher in the uppermost quartile (model 3, quartile 4: odds ratio, 6.78; 95% confidential interval, 1.67 to 27.56); however, serum homocysteine levels in women were not associated with non-alcoholic fatty liver disease in the crude model or in models adjusted for confounders.

Conclusion

Serum homocysteine levels were associated with the prevalence of non-alcoholic fatty liver disease in men.

Citations

Citations to this article as recorded by  
  • Homocysteine, folate, and nonalcoholic fatty liver disease: a systematic review with meta-analysis and Mendelian randomization investigation
    Shuai Yuan, Jie Chen, Lintao Dan, Ying Xie, Yuhao Sun, Xue Li, Susanna C Larsson
    The American Journal of Clinical Nutrition.2022; 116(6): 1595.     CrossRef
  • Genetic Association of Plasma Homocysteine Levels with Gastric Cancer Risk: A Two-Sample Mendelian Randomization Study
    Tianpei Wang, Chuanli Ren, Jing Ni, Hui Ding, Qi Qi, Caiwang Yan, Bin Deng, Juncheng Dai, Gang Li, Yanbing Ding, Guangfu Jin
    Cancer Epidemiology, Biomarkers & Prevention.2020; 29(2): 487.     CrossRef
  • Characterization of Early-Stage Alcoholic Liver Disease with Hyperhomocysteinemia and Gut Dysfunction and Associated Immune Response in Alcohol Use Disorder Patients
    Vatsalya Vatsalya, Khushboo S. Gala, Ammar Z. Hassan, Jane Frimodig, Maiying Kong, Nachiketa Sinha, Melanie L. Schwandt
    Biomedicines.2020; 9(1): 7.     CrossRef
  • Sex differences in risk factors for stroke in patients with hypertension and hyperhomocysteinemia
    Hui Pang, Qiang Fu, Qiumei Cao, Lin Hao, Zhenkun Zong
    Scientific Reports.2019;[Epub]     CrossRef
  • Association between homocysteine and non-alcoholic fatty liver disease in Chinese adults: a cross-sectional study
    Haijiang Dai, Weijun Wang, Xiaohong Tang, Ruifang Chen, Zhiheng Chen, Yao Lu, Hong Yuan
    Nutrition Journal.2016;[Epub]     CrossRef
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  • 8 Web of Science
  • 5 Crossref
Effect of Alcohol Consumption on Risk of Hyperhomocysteinemia Based on Alcohol-Related Facial Flushing Response
Eo-Chin Kim, Jong Sung Kim, Jin-Gyu Jung, Sung-Soo Kim, Seok-Joon Yoon, Jung-Sun Ryu
Korean J Fam Med 2013;34(4):250-257.   Published online July 24, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.4.250
Background

This study examined the relationship between alcohol consumption and hyperhomocysteinemia based on facial flushing caused by drinking.

Methods

Among male patients aged ≥ 18 years who visited Health Promotion Center of Chungnam National University Hospital in Daejeon from January 2008 to December 2010, 948 males (182 nondrinkers, 348 subjects with drinking-related facial flushing, and 418 subjects without drinking-related facial flushing) were selected. After adjusting for confounding factors such as age, body mass index, hypertension, diabetes, smoking, triglycerides, high density lipoprotein cholesterol, and gamma-glutamyl transpeptidase, a multiple logistic regression analysis was performed to assess the risk of hyperhomocysteinemia in the nonfacial flushing and facial flushing groups compared with the nondrinkers.

Results

After adjusting for confounding factors, risk of hyperhomocysteinemia was significantly lower in the group with a weekly alcohol consumption of < 8 standard drinks (1 drink = 14 g alcohol) in the nonfacial flushing group (<4 drinks: odds ratio [OR], 0.27; 95% confidence interval [CI], 0.10 to 0.74; 4≤, <8 drinks: OR, 0.21; 95% CI, 0.06 to 0.73). Risk of hyperhomocysteinemia was significantly lower in the group with a weekly alcohol consumption < 4 drinks in the facial flushing group (OR, 0.30; 95% CI, 0.13 to 0.68).

Conclusion

Our results suggest that the risk of hyperhomocysteinemia is likely lowered by alcohol consumption based on drinking quantity, as lowering the risk of hyperhomocysteinemia differs depending on vulnerability associated with facial flushing.

Citations

Citations to this article as recorded by  
  • Guidelines for an alcohol clinic in primary healthcare clinics
    Jin-Gyu Jung, Jong-Sung Kim, Seok-Joon Yoon, Jang-Hee Hong, Jung Sunwoo
    Journal of the Korean Medical Association.2024; 67(4): 256.     CrossRef
  • Characteristics of the Intestinal Microorganisms in Middle-Aged and Elderly Patients: Effects of Smoking
    Hai-Tao Yang, Wen-Juan Xiu, Jing-Kun Liu, Yi Yang, Yan-jun Zhang, Ying-Ying Zheng, Ting-Ting Wu, Xian-Geng Hou, Cheng-Xin Wu, Yi-Tong Ma, Xiang Xie
    ACS Omega.2022; 7(2): 1628.     CrossRef
  • Characteristics of the Gut Microbiome of Healthy Young Male Soldiers in South Korea: The Effects of Smoking
    Hyuk Yoon, Dong Ho Lee, Je Hee Lee, Ji Eun Kwon, Cheol Min Shin, Seung-Jo Yang, Seung-Hwan Park, Ju Huck Lee, Se Won Kang, Jung-Sook Lee, Byung-Yong Kim
    Gut and Liver.2021; 15(2): 243.     CrossRef
  • Korean Alcohol Guidelines for Primary Care Physician
    Jin-Gyu Jung, Jong-Sung Kim, Seok-Joon Yoon, Sami Lee, Soon-Ki Ahn
    Korean Journal of Family Practice.2021; 11(1): 14.     CrossRef
  • Gut Microbiota Characterization in Patients with Asymptomatic Hyperuricemia: probiotics increased
    Hai-Tao Yang, Wen-Juan Xiu, Jing-Kun Liu, Yi Yang, Xian-Geng Hou, Ying-Ying Zheng, Ting-Ting Wu, Chen-Xin Wu, Xiang Xie
    Bioengineered.2021; 12(1): 7263.     CrossRef
  • Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing
    Sami Lee, Jong-Sung Kim, Jin-Gyu Jung, Mi-Kyeong Oh, Tae-Heum Chung, Jihan Kim
    Korean Journal of Family Medicine.2019; 40(4): 204.     CrossRef
  • Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder
    Seong Gu Kim, Jong Sung Kim, Han Ju Pack, Han Na Sung
    Korean Journal of Health Promotion.2017; 17(2): 91.     CrossRef
  • Drinking Amount Associated with Abnormal Gamma-Glutamyl Transpeptidase Expression in Women
    Jun-Seok Yang, Jong-Sung Kim, Won-Yoon Seo, Sir-Chae Paik
    Korean Journal of Family Medicine.2016; 37(1): 2.     CrossRef
  • The Relationship between Uric Acid and Homocysteine Levels based on Alcohol-related Facial Flushing
    Eo Chin Kim, Jong Sung Kim, Won Chul Uh, Soo Young Choi, Sun Kyung Lee, Bog Seon Jeong
    Korean Journal of Health Promotion.2015; 15(3): 91.     CrossRef
  • Breaking the Misconception about Alcohol: Go with the Light, Out of the Monochrome
    Seung-Won Oh
    Korean Journal of Family Medicine.2014; 35(6): 263.     CrossRef
  • Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk
    Hae Sun Suh, Jong Sung Kim, Sung Soo Kim, Jin Gyu Jung, Seok Jun Yoon, Jae Bum Ahn
    Korean Journal of Family Medicine.2014; 35(6): 295.     CrossRef
  • Comments on Statistical Issues in September 2013
    Yong Gyu Park
    Korean Journal of Family Medicine.2013; 34(5): 369.     CrossRef
  • 4,300 View
  • 28 Download
  • 12 Crossref
The Relationship between Daily Calcium Intake and Plasma Homocysteine Concentrations in Adults.
Eugene Kim, Kyung Jong Lee, Jae Bum Park, Sat Byul Park
Korean J Fam Med 2010;31(2):101-107.   Published online February 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.2.101
Background
Elevated plasma total homocysteine causes the risk of cardiovascular diseases. By reducing plasma total homocysteine may prevent cardiovascular diseases. Many studies showed that vitamin B12 and folic acid decrease homocysteine level when taken with calcium fortified drinking water. Our aim of this study was to demonstrate the association between plasma homocysteine concentrations and daily calcium intake. Methods: Among 636 adults aged 40-69 years who visited a health promotion center of a university hospital from May 2006 to April 2007, the study subjects were 567 who completed self-reported questionnaire. Self-reported calcium intake amount and their baseline health questionnaire were obtained. We measured height and weight by physical examination. Through blood test, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, plasma creatinine and homocysteine level were evaluated. Results: The mean daily calcium intake of entire subjects was 770.1 ± 266.3 mg. The mean plasma homocysteine concentration was 10.6 ± 4.3 Ռmol/L. The multiple regression analysis showed significant correlations between plasma homocysteine level and body mass index, plasma creatinine level and calcium intake. Plasma homocysteine level was inversely associated with dietary calcium intake. Conclusion: We found the calcium was inversely associated and homocysteine level an independent risk factor of cardiovascular diseases. However, further studies should be established to confirm if greater calcium intake may lower plasma homocysteine level.

Citations

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  • Consumption of very low-mineral water may threaten cardiovascular health by increasing homocysteine in children
    Yujing Huang, Yao Tan, Lingqiao Wang, Lan Lan, Jiaohua Luo, Jia Wang, Hui Zeng, Weiqun Shu
    Frontiers in Nutrition.2023;[Epub]     CrossRef
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  • 26 Download
  • 1 Crossref
Relationship of Serum Homocysteine with Brachial-Ankle Pulse Wave Velocity in Middle Aged Women.
Byoung Jin Park, Hye Yun Chun, Ah Reum Han, Ji Ae Lim, Duk Chul Lee, Jae Yong Shim, Hye Ree Lee
Korean J Fam Med 2009;30(6):457-463.   Published online June 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.6.457
Background
Several studies showed the relationship between serum homocysteine and pulse wave velocity, but their subjects were confi ned to high risk group for cardiovascular diseases and recent study revealed no relationship in young healthy adults. We hypothesized that time interval would be needed for serum homocysteine to infl uence pulse wave velocity after exposure to vascular endothelium. The purpose of this study was to determine the relationship between serum homocysteine and pulse wave velocity in middle aged women on the basis of that hypothesis and necessity for further study in general population.Methods: The study subjects were 110 middle aged women who visited a health promotion center of a general hospital. We collected medical history by means of self-reported questionnaire and measured height, weight, blood pressure and brachial-ankle pulse wave velocity (baPWV). Blood sampling was performed after overnight fasting. We analyzed the relationship between several cardiovascular risk factors and baPWV and performed multiple regression analysis.Results: BaPWV velocity was correlated signifi cantly with age, mean blood pressure, serum homocysteine, total cholesterol and diabetes mellitus, but not with body mass index, high-density lipoprotein cholesterol, triglyceride, creatinine clearance, alcohol intake, hypertension and smoking. In multiple regression, there was a signifi cant association between age (P = 0.04), moderate hyperhomocysteinemia (P = 0.02), mean blood pressure (P < 0.001) and baPWV.Conclusion: In middle aged women, there was an independently positive association between serum homocysteine and baPWV.

Citations

Citations to this article as recorded by  
  • Borderline-High Mean Corpuscular Volume Levels Are Associated with Arterial Stiffness among the Apparently Healthy Korean Individuals
    Haneul Kwon, Byoungjin Park
    Korean Journal of Family Medicine.2020; 41(6): 387.     CrossRef
  • 2,056 View
  • 16 Download
  • 1 Crossref
Association between Plasma Homocysteine Level and Brachial-ankle Pulse Wave Velocity in Korean Adults.
Kyung Sun Yoon, Sang Whan Kim, Hee Jeong Choi
Korean J Fam Med 2009;30(1):46-54.   Published online January 10, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.1.46
Background
Elevated plasma homocysteine appears to be causally related to atherosclerosis by inducing both endothelial dysfunction and vascular structure alteration. Brachial-ankle pulse wave velocity, a non invasive means of measuring atherosclerosis, reflects arterial stiffness. In this study, we investigated a association between the plasma homocysteine level and arterial stiffness on Korean adults. Methods: The study group comprised 405 subjects selected from examinees in the Health Promotion Center. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured glucose tolerance index, lipid profile, inflammatory index, plasma homocysteine level. We studied brachial-ankle pulse wave velocity (baPWV) as a measure of arterial stiffness. Results: 379 subjects were examined all components. Mean ages of 172 of male are 54.5 ± 8.7 years and those of female are 57.2 ± 7.0 years. The baPWV was observed to be positively correlated with age, blood pressure, hs-CRP, and homocysteine in male. In contrast male, age, BMI, waist circumference, blood pressure, glucose tolerance index, lipid profile except for HDL cholesterol, hs-CRP, and homocysteine were positively correlated with baPWV in female. The baPWV was increased according to the level of plasma homocysteine in male. After controlling for risk factors of cardiovascular disease ,homocysteine was associated with increased baPWV. Conclusion: The results indicate that elevated plasma homocysteine was associated with baPWV in middle-aged male after adjustment to risk factors of cardiovascular disease.

Citations

Citations to this article as recorded by  
  • Borderline-High Mean Corpuscular Volume Levels Are Associated with Arterial Stiffness among the Apparently Healthy Korean Individuals
    Haneul Kwon, Byoungjin Park
    Korean Journal of Family Medicine.2020; 41(6): 387.     CrossRef
  • Relationship of Serum Homocysteine with Brachial-Ankle Pulse Wave Velocity in Middle Aged Women
    Byoung-Jin Park, Hye-Yun Chun, Ah-Reum Han, Ji-Ae Lim, Duk-Chul Lee, Jae-Yong Shim, Hye-Ree Lee
    Korean Journal of Family Medicine.2009; 30(6): 457.     CrossRef
  • 2,223 View
  • 19 Download
  • 2 Crossref
Association between Metabolic Syndrome and Plasma Homocysteine among Korean Adults.
Kyung Sun Yoon, Hee Jeong Choi, Jee Aee Im, Joo Ho Yoon, Sang Hwan Kim
J Korean Acad Fam Med 2008;29(7):499-505.   Published online July 10, 2008
Background: Elevated plasma homocysteine is an independent risk factor for cardiovascular diseases caused by atherosclerosis. Previous studies have shown that plasma homocysteine is associated with components of the metabolic syndrome such as hypertension, insulin resistance, and dyslipidemia. In this study, we investigated the association between the plasma homocysteine levels and the metabolic syndrome on Korean adults. Methods: The study group with the metabolic syndrome and the control group without the metabolic syndrome were selected from the examinees of equivalent age and gender in the Health Promotion Center. Among the subjects, 107 adults with the metabolic syndrome and 123 adults without the metabolic syndrome were categorized into the study and the control groups, respectively. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured fasting glucose, total cholesterol, triglycerides, high-density lipoprotein, hs-CRP, homocysteine levels and others by blood sampling. The metabolic syndrome was defined by the criteria for clinical diagnosis of the metabolic syndrome by AHA/NHLBI. Results: The mean ages in the study group and the control group were 54.6±9.3 and 54.6±8.7 years, respectively, and the numbers of males 29 (27.1%) and 39 (31.7%), respectively. The plasma homocysteine was observed to be positively correlated with age, waist circumference, diastolic blood pressure, apolipoprotein A-1, fasting glucose, fasting insulin, HOMA-IR, and hs-CRP. Among the components of the metabolic syndrome, hypertension showed a strong correlation with the levels of the plasma homocysteine (10.62±3.92 ųmol/L vs. 9.09± 2.63 ųmol/L, P=0.001), whereas hyperglycemia, abdominal obesity, and dyslipidemia did not correlate with the levels of plasma homocysteine. Adjusted homocysteine levels to age, gender, alcohol drinking history, and smoking history was still higher in the study group compared to those in the control group (10.320±0.290 ųmol/L vs. 10.320±0.290 ųmol/L, P=0.017). Conclusion: The results indicate that the metabolic syndrome leads to a higher level of homocysteine in adults after adjustment to age, gender, alcohol drinking history, and smoking history. (J Korean Acad Fam Med 2008;29:499-505)
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The Relationship of Serum Homocysteine Levels with Lumbar and Femoral Bone Mineral Density.
Yoen Jung Lee, Sang Wha Lee, Hong Soo Lee, Kyung Won Shim, Sooa Kim, Eui Jeong Woo, Na Yeon Kim
J Korean Acad Fam Med 2008;29(3):175-181.   Published online March 10, 2008
Background
Recently, an elevated serum homocysteine level has been reported to be associated with increased fracture risk and reduced bone mineral density (BMD). So far, little research has been done to evaluate such association in Korean population. Therefore, we investigated the association between serum homocysteine levels and BMD in Korean adults. Methods: The subjects consisted of 2,750 adults who visited a health promotion center at a university hospital from January 2005 to March 2006. Self-administered questionnaires provided information about lifestyle and medical history. Fasting plasma samples were collected and BMD of the lumbar spine and femoral neck were obtained by dual energy X-ray absorptiometry. To adjust for menopausal state, the female subjects were divided into three groups according to age (≤45 yrs, 46∼55 yrs, 55 yrs <). Multiple linear regression analysis was used to evaluate the association between serum homocysteine levels and BMD in each gender and age group. Results: The results adjusted for alcohol and smoking history showed significant association between serum homocysteine levels and BMD in women (Lumbar spine: Ղ=-0.006, P=0.015, Femoral neck: Ղ=-0.065, P=0.012) but not in men (Lumbar spine: Ղ=0.001, P=0.240, Femoral neck: Ղ=0.001, P=0.242). With analyses by three age groups, plasma homocysteine level was associated with both lumbar and femoral BMD in age 46∼55 women (Lumbar spine: Ղ=-0.014, P=0.024, Femoral neck: Ղ= -0.007, P=0.019). Conclusion: Our study suggests that increased serum homocysteine level is an independent risk factor for low BMD among women, especially perimenopausal women. Further studies about the sexual differences and the mechanisms linking serum homocysteine level to BMD are needed. (J Korean Acad Fam Med 2008;29:175-181)
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Hyperhomocysteinemia and Cerebrovascular Diseases in Koreans.
Bu Kyoung Yoon, Chul Gab Lee, Rae Sang Kim, Man Jin Cha
J Korean Acad Fam Med 2006;27(1):12-20.   Published online January 10, 2006
Background
: Hyperhomocysteinemia as a risk factor for cerebrovascular disease is well known. Our aim of this study was to demonstrate positive association between elevated homocysteine levels and cerebrovascular diseases in Koreans.

Methods : With a case-control design, 186 stroke (infarction 134, hemorrhage 52) patients, diagnosed by brain CT or MRI and 359 control patients were evaluated. We used multiple logistic regression analyses conditioned on the matching variables (sex, age, hypertension, DM, smoking, hyperlipidemia, hyperhomocysteinemia) and calculated odds ratio and 95% CIs.

Results : Multivariate adjusted odds ratios (OR) for cerebrovascular diseases associated with hypertension compared with normal blood pressure were 2.45 (95% CI, 1.16 to 5.15) in prehypertension and 3.33 (95% CI, 1.56 to 7.10) in stage 1 hypertension and 3.77 (95% CI, 1.32 to 10.74) in stage 2 hypertension. OR for cerebrovascular diseases associated with hyperhomocysteinemia compared with <10μmol/L were 2.06 (95% CI, 1.09 to 3.91) in 13.0 to 16.9μmol/L and 3.17 (95% CI, 1.70 to 5.90) in ≥17μmol/L.

Conclusion : Not only hypertension but also hyperhomocysteinemia was a significant risk factor for cerebrovascular diseases in Koreans.
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Serum Homocysteine and Its Relevant Factors among Health Screeners in a University Hospital.
Dong Kuk Lee, Hyun Kook Choi, Jung Cheon Son, Yoo Ji Chung, Bom Taeck Kim, Kwang Min Kim
J Korean Acad Fam Med 2005;26(11):671-679.   Published online November 10, 2005
Background
: Elevated plasma total homocysteine is a risk factor for cardiovascular diseases. The authors investigated the parameters such as habit, body index, cardiovascular risk factors, nutrition relative to the plasma homocysteine concentration.

Methods : The subjects were 6,223 adults (3,377 males, 2,846 females) who were over 18 years of age and visited a health promotion center of a university hospital from March 2002 to January 2003. We assessed the relationship between the homocysteine level and the following parameters: sex, age, weight, body mass index, waist circumference, smoking, alcohol, systolic and diastolic blood pressure (BP), triglyceride, total cholesterol, high density lipoprotein cholesterol, creatinine, albumin and hemoglobin.

Results : The homocysteine levels was 10.5±5.9μmol/L in males, 7.3±2.6μmol/L in female. Thus it was significantly higher in males (P<0.001). After adjusting for variables that affect the homocysteine, the subjects over the age of 54 showed 10.7μmol/L (9.5, 12.0, 95% Confidence Interval), which was significantly (P=0.002) higher than the below the age of 38 groups 8.5μmol/L (7.8, 9.2, 95% CI). Non-smoking group showed 8.6μmol/L (8.4, 8.9, 95% CI), while over 28 pack-year group showed 9.6μmol/ L (9.2, 10.0, 95% CI), which was significantly (P<0.001) higher than the non-smoking groups. For the group with systolic BP over 132mmHg, it was 9.3μmol/L (8.8, 9.5, 95% CI). This was significantly (P=0.004) higher than 8.7μmol/L (8.4, 9.0, 95% CI) in the group whose systolic BP was less than 108 mmHg. The homocysteine was 10.4μmol/L (10.1, 11.7, 95% CI) for the group with creatinine over 1.0 mg/dL, which was significantly (P<0.001) higher than 7.9μmol/L (7.6, 8.2, 95% CI) in the group whose creatinine was less than 0.8 mg/dL.

Conclusion : After adjusting for variables that affect the homocysteine, significant difference in its values was found between males and females. The homocysteine was significantly increased in the group whose age, systolic BP, amount of smoking, and creatinine were higher.
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