title: Serum homocysteine is weakly associated with von Willebrand factor and soluble vascular cell adhesion molecule 1, but not with C-reactive protein in type 2 diabetic and non-diabetic subjects - The Hoorn Study.
abstract: BACKGROUND
  Hyperhomocysteinaemia may constitute an independent risk factor for cardiovascular disease, but it is still unclear by which pathophysiological mechanisms homocysteine (tHcy) may promote atherothrombosis. The aim of this study was firstly to examine whether tHcy is associated with endothelial dysfunction, increased adherence of leukocytes, and/or chronic low-grade inflammation, as estimated from plasma levels of von Willebrand factor (vWf), soluble vascular cell adhesion molecule 1 (sVCAM-1) and C-reactive protein (CRP), respectively. Secondly we investigated whether the presence of type 2 diabetes modifies these associations.
  
  
  METHODS
  Six hundred and ten subjects of a general population of middle-aged and elderly subjects, 170 of whom had type 2 diabetes, participated in this cross-sectional study. Linear regression analyses were used to study whether tHcy was associated with vWf, sVCAM-1 and CRP, and whether the presence of diabetes modified these associations.
  
  
  RESULTS
  After adjustment for confounders, tHcy was significantly but weakly associated with vWf (beta = 0.15, P = 0.05) and sVCAM-1 (beta = 0.082, P = 0.04). tHcy was not significantly associated with CRP (beta = 0.02, P = 0.91). The presence of diabetes did not significantly modify these associations.
  
  
  CONCLUSIONS
  This study provides evidence that tHcy is, at most, weakly associated with endothelial dysfunction as estimated from plasma vWf, and with leukocyte adhesion as estimated from plasma sVCAM-1. tHcy was not significantly associated with chronic low-grade inflammation as estimated from plasma CRP. Our data thus suggest that the link between tHcy and atherothrombosis cannot be explained by associations of tHcy with vWf, sVCAM-1 or CRP.
authors.affiliation: Vrije Universiteit, Amsterdam, The Netherlands; TNO Prevention and Health, Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Becker
authors.forename: V W
authors.initials: VW
authors.lastname: Van Hinsbergh
authors.forename: P J
authors.initials: PJ
authors.lastname: Kostense
authors.forename: A
authors.initials: A
authors.lastname: Jager
authors.forename: J M
authors.initials: JM
authors.lastname: Dekker
authors.forename: G
authors.initials: G
authors.lastname: Nijpels
authors.forename: R J
authors.initials: RJ
authors.lastname: Heine
authors.forename: L M
authors.initials: LM
authors.lastname: Bouter
authors.forename: C D
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D015815:Cell Adhesion Molecules / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D015815:Cell Adhesion Molecules; D014841:von Willebrand Factor; D006710:Homocysteine; D002097:C-Reactive Protein