Hyperhomocyst(e)inemia and hemostatic factors: the atherosclerosis risk in communities study.
OBJECTIVE
To determine whether homocyst(e)ine (H(e)) is related to hemostatic factors in a population-based sample without evidence of cardiovascular disease.


METHODS
A subsample of 660 participants--67 African-American women, 53 African-American men, 201 white women, and 339 white men--was selected from the Atherosclerosis Risk in Communities Study baseline cohort. This was based on carotid intimal-medial wall thickness above the 90th percentile or below the 75th percentile of the population distribution, assessed by B-mode ultrasonography. Unadjusted and multivariable-adjusted associations between fasting plasma H(e) and the hemostatic factors fibrinogen, factor VII:c, factor VIII:c, protein C antigen, hematocrit, platelet count, beta-thromboglobulin (beta-TG), tissue plasminogen activator (tPA), PAI-1, D-dimer, and lipoprotein[a] were examined.


RESULTS
Mean age-adjusted H(e) was positively, albeit weakly, correlated with beta-TG, tPA, hematocrit, D-dimer and PAI-1; inversely correlated with protein C; and was higher in smokers, men and African-Americans. In multivariable regression, beta-TG, tPA, and factor VII:c were positively associated with H(e), as well as age, black race, male sex, and current cigarette smoking.


CONCLUSIONS
These cross-sectional data for a biracial group of middle-aged individuals suggest that H(e) levels falling below values consistent with homocyst(e)inemia are associated with several prothrombotic factors after adjustment for sociodemographic factors. If H(e) change is antecedent to altered hemostasis, FDA-mandated fortification of grain products with folic acid for prevention of fetal neural tube defects may lead to both reduced plasma H(e) levels and improved hemostatic profiles.
Schreiner
Pamela J
PJ
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454-1015, USA. schreiner@epivax.epi.umn.edu
Wu
Kenneth K
KK
Malinow
M Rene
MR
Stinson
Valarie L
VL
Szklo
Moyses
M
Nieto
F Javier
FJ
Heiss
Gerardo
G
D000367:Age Factors; D001161:Arteriosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D001779:Blood Coagulation Factors / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006487:Hemostasis; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking; D014463:Ultrasonography
D001779:Blood Coagulation Factors; D006710:Homocysteine