Hyperhomocysteinemia and venous thrombosis: a meta-analysis.
Hyperhomocysteinemia is an established risk factor for atherosclerosis and vascular disease. Until the early nineties the relationship with venous thrombosis was controversial. At this moment ten case-control studies on venous thrombosis are published. We performed a metaanalysis of these reports. We performed a MEDLINE-search from 1984 through June 1997 on the keywords "homocysteine" or "hyperhomocysteinemia" and "venous thrombosis", which yielded ten eligible case-control studies. We found a pooled estimate of the odds ratio of 2.5 (95% CI 1.8-3.5) for a fasting plasma homocysteine concentration above the 95th percentile or mean plus two standard deviations calculated from the distribution of the respective control groups. For the post-methionine increase in homocysteine concentration we found a pooled estimate of 2.6 (95% CI 1.6-4.4). These data from case-control studies support hyperhomocysteinemia as a risk factor for venous thrombosis. Further research should focus on the pathophysiology of this relationship and on the clinical effects of reducing homocysteine levels by vitamin supplementation.
den Heijer
M
M
Department of Hematology, Leyenburg Hospital, The Hague, The Netherlands. m.denheijer@AIG.AZN.NL
Rosendaal
F R
FR
Blom
H J
HJ
Gerrits
W B
WB
Bos
G M
GM
D000328:Adult; D016022:Case-Control Studies; D005215:Fasting / Q000097:blood; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008715:Methionine; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000453:epidemiology*
D006710:Homocysteine; D008715:Methionine