Levels of homocysteine are increased in metabolic syndrome patients but are not associated with an increased cardiovascular risk, in contrast to patients without the metabolic syndrome

Aim: The metabolic syndrome is associated with increased cardiovascular risk. Elevated plasma homocysteine may cause or result from insulin resistance, and may indicate vascular risk or be actively involved in atherogenesis. The aim of the study was to investigate the relationship between homocystei...

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Veröffentlicht in:Heart (British Cardiac Society) Jg. 93; H. 2; S. 216 - 220
Hauptverfasser: Hajer, Gideon R, van der Graaf, Yolanda, Olijhoek, Jobien K, Verhaar, Marianne C, Visseren, Frank L J
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.02.2007
BMJ
BMJ Publishing Group LTD
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Schlagworte:
95% CI
95% confidence intervals
Adult
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Biomarkers - blood
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular disease
Cerebrovascular Disorders - blood
Chelating Agents
Coronary Disease - blood
Diabetes, Lipids and Metabolism
Female
hazard ratio
Health risk assessment
Heart attacks
homocysteine
Homocysteine - blood
Humans
Insulin resistance
Male
Medical sciences
Metabolic diseases
Metabolic syndrome
Metabolic Syndrome - blood
Methionine
Middle Aged
Miscellaneous
Other metabolic disorders
Peripheral Vascular Diseases - blood
Proportional Hazards Models
Risk Assessment
standard deviation
Studies
Endocrinopathy
Human
Metabolic diseases
Cardiovascular disease
Patient
Contrast
Phlebology
Vascular disease
Association
Homocystein
X Syndrome
Atherosclerosis
Risk factor
Cardiovascular risk
Circulatory system
Cardiology
ISSN:1355-6037, 1468-201X, 1468-201X
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Zusammenfassung:Aim: The metabolic syndrome is associated with increased cardiovascular risk. Elevated plasma homocysteine may cause or result from insulin resistance, and may indicate vascular risk or be actively involved in atherogenesis. The aim of the study was to investigate the relationship between homocysteine, the metabolic syndrome and the incidence of cardiovascular events in patients with manifest vascular disease. Methods: A cohort of 2169 patients with manifest vascular disease was followed for a mean period of 2.8 years. Plasma homocysteine was measured at baseline. Metabolic syndrome was defined by NCEP criteria. Results: Homocysteine levels were higher in metabolic syndrome patients compared to patients without the metabolic syndrome (14.9±0.2 v 14.1±0.2 μmol/l; p = 0.002) and increased with the presence of its components (from 0 to 5) (12.7 to 15.9 μmol/l; p<0.001). During follow-up, 52 strokes, 67 myocardial infarctions, 5 fatal ruptures of aortic aneurysms and 53 vascular deaths occurred. Patients without the metabolic syndrome and homocysteine levels in the highest tertile had increased risk for events (HR 1.9; 95% CI 1.0 to 3.5) compared to patients without the metabolic syndrome and homocysteine levels in the lowest tertile. The presence of the metabolic syndrome increased the risk (HR 2.2; 95% CI 1.2 to 4.2), but elevated homocysteine levels further increased the risk only marginally (2.5; 95% CI 1.4 to 4.6). Conclusions: Metabolic syndrome patients have elevated homocysteine levels, but these higher levels are not associated with an increased risk for new cardiovascular events. In contrast, elevated homocysteine levels confer increased risk in patients without the metabolic syndrome.
Bibliographie:local:0930216
Correspondence to:
 F L J Visseren
 Internal Medicine, Section of Vascular Medicine, UMC Utrecht, F.02.126, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; F.L.J.Visseren@umcutrecht.nl
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href:heartjnl-93-216.pdf
PMID:16952974
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Participants of the SMART study group (for coordination and supervision of the cohort) are: A Algra, MD, PhD; Y van der Graaf, MD, PhD; DE Grobbee, MD, PhD; GEHM Rutten, MD, PhD, Julius Centre for Health Sciences and Primary Care; FLJ Visseren, MD, PhD, Department of Internal Medicine; BC Eikelboom, MD, PhD; FL Moll, MD, PhD, Department of Vascular Surgery; LJ Kappelle, MD, PhD, Department of Neurology; HA Koomans MD, PhD, Department of Nephrology; WPThM Mali, MD, PhD, Department of Radiology; PA Doevendans, MD, PhD, Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
ISSN:1355-6037
1468-201X
1468-201X
DOI:10.1136/hrt.2006.093971