title: Lack of association between plasma homocysteine and inflammation in psychogeriatric patients.
abstract: OBJECTIVE
  In previous studies we observed a high incidence of elevated plasma homocysteine (tHcy) concentrations in psychogeriatric patients. Plasma tHcy is increased in folate deficiency. Folates are sensitive to oxidative stress. Oxidative stress, caused by inflammatory processes, could represent an endogenous reason for folate deficiency, even when the dietary intake of the vitamin is within the recommended range. It has been suggested that oxidative stress rather than insufficient folate intake causes hyperhomocysteinemia in different forms of psychogeriatric diseases. In the present study we investigated the association between plasma tHcy and C-reactive protein (CRP), a sensitive marker for inflammation, in psychogeriatric patients.
  
  
  METHODS
  Plasma tHcy, its main determinants, and CRP were measured in plasma and serum of 132 psychogeriatric patients (53 males and 79 females, mean age 75 +/- 12 years).
  
  
  RESULTS
  In the psychogeriatric patients, plasma tHcy was elevated and blood folate and serum creatinine were lower than in control subjects, whereas serum CRP concentrations did not differ significantly. We also subdivided the psychogeriatric patients into different diagnosis groups, yet there were no differences in serum CRP concentrations in these groups compared with age-matched control groups. There was a significant correlation between plasma tHcy and serum CRP (rho = 0.19, p < 0.05). A stepwise multiple regression analysis including serum CRP, age, blood folate, serum cobalamin, serum methylmalonic acid and serum creatinine showed that only blood folate (p < 0.001), age (p < 0.001), serum creatinine (p < 0.001), serum cobalamin (p < 0.001), and serum methylmalonic acid (p < 0.001) independently predicted plasma tHcy concentration. Thus CRP concentration was not an independent predictor of plasma tHcy.
  
  
  CONCLUSIONS
  The present study did not show any association between inflammatory status and plasma tHcy concentration in psychogeriatric patients.
authors.affiliation: Department of Psychogeriatrics, Division of Clinical Chemistry, University Hospital, Lund, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Nilsson
authors.forename: Björn
authors.initials: B
authors.lastname: Hultberg
authors.forename: Lars
authors.initials: L
authors.lastname: Gustafson
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D003404:Creatinine / Q000097:blood; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000097:blood*; D012494:Sampling Studies
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid; D003404:Creatinine