title: Hyperhomocysteinemia and risk for peripheral arterial occlusive disease in young women.
abstract: OBJECTIVE
  Few studies to date have examined the relationship between hyperhomocysteinemia and peripheral arterial occlusive disease (PAOD) in young women. In this study we assessed hyperhomocysteinemia as a risk factor for PAOD in young women. In addition, we evaluated the effect of joint exposure to hyperhomocysteinemia and traditional risk factors.
  
  
  METHODS
  Two hundred twenty women, ages 18 to 49 years, with PAOD and 629 healthy women (control group) from a population-based case-control study filled out the same structured questionnaire and donated venous blood samples for determination of plasma homocysteine levels. Hyperhomocysteinemia was defined as nonfasting total plasma homocysteine level above the 90th percentile of the control range.
  
  
  RESULTS
  Young women with hyperhomocysteinemia had a 2.5-fold (95% confidence interval [CI], 1.7-3.9) increased risk for PAOD. When presence of hyperhomocysteinemia was combined with presence of a traditional risk factor, relative risk strongly increased in smokers (odds ratio [OR], 18.9; 95% CI, 8.3-42.9) and in women with hypertension (OR, 10.3; 95% CI, 5.4-19.8), hypercholesterolemia (OR, 8.5; 95% CI, 4.2-17.1), and diabetes (OR, 8.9; 95% CI, 1.7-46.9).
  
  
  CONCLUSIONS
  Hyperhomocysteinemia is a risk factor for PAOD in young women. There is a strong synergistic effect between hyperhomocysteinemia and all traditional vascular risk factors. Our findings may have implications for risk management in these young women.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
authors.forename: Daisy G M
authors.initials: DG
authors.lastname: Bloemenkamp
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Jeanet M
authors.initials: JM
authors.lastname: Kemmeren
authors.forename: Bea C
authors.initials: BC
authors.lastname: Tanis
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
mesh_terms: D000293:Adolescent; D000328:Adult; D001157:Arterial Occlusive Diseases / Q000209:etiology*; D001161:Arteriosclerosis / Q000209:etiology; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000209:etiology*; D012307:Risk Factors