title: Low plasma levels of vitamin B(6) are independently associated with a heightened risk of deep-vein thrombosis.
abstract: BACKGROUND
  Elevated plasma levels of total homocysteine (tHcy) before and after an oral methionine load (PML) are associated with an elevated risk of deep-vein thrombosis (DVT). We investigated whether plasma levels of B vitamins that are involved in Hcy metabolism are associated with an elevated risk of DVT.
  
  
  RESULTS
  We compared 397 cases with previous DVT with 585 matched healthy controls. The plasma levels of folate, vitamin B(12), vitamin B(6,), and fasting and PML tHcy were measured. The ORs for DVT associated with high (>95th percentile) fasting levels and PML increases of tHcy were 2.1 (95% CI, 1.2 to 3.4) and 2.4 (95% CI, 1.5 to 3.9) after adjustment for established risk factors for DVT. Fasting plasma levels and PML increases in tHcy correlated negatively with vitamin levels. The crude OR for folate levels in the lowest quartile compared with the highest was 1.5 (95% CI, 1.1 to 2.1), and that for B(6) levels in the lowest and second quartiles compared with the highest was 1.5 (95% CI, 1.0 to 2.1). However, after adjustment for established risk factors and fasting and PML tHcy, the ORs for B(6) levels in the lowest and second quartiles only remained statistically significant (lowest quartile: OR, 1.8; 95% CI, 1.2 to 2.8; second quartile, OR, 1.9; 95% CI, 1.3 to 2.9).
  
  
  CONCLUSIONS
  High fasting and PML tHcy and low vitamin B(6) plasma levels are associated with an elevated risk for DVT independently of established risk factors for DVT. The association of low vitamin B(6) levels with the risk for DVT is independent of fasting and PML tHcy levels.
authors.affiliation: . Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine, IRCCS Ospedale Maggiore, University of Milano, Milano, Italy. marco.cattaneo@unimi.it
authors.forename: M
authors.initials: M
authors.lastname: Cattaneo
authors.forename: R
authors.initials: R
authors.lastname: Lombardi
authors.forename: A
authors.initials: A
authors.lastname: Lecchi
authors.forename: P
authors.initials: P
authors.lastname: Bucciarelli
authors.forename: P M
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005215:Fasting; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008715:Methionine / Q000008:administration & dosage; D008875:Middle Aged; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology*; D014805:Vitamin B 12 / Q000097:blood; D025101:Vitamin B 6 / Q000097:blood*
chemical_list: D006710:Homocysteine; D025101:Vitamin B 6; D005492:Folic Acid; D008715:Methionine; D014805:Vitamin B 12