title: Folate and cobalamin synergistically decrease the risk of high plasma homocysteine in a nonsupplemented elderly institutionalized population.
abstract: OBJECTIVE
  Total plasma homocysteine (tHcy) has been associated with an increased risk of cardiovascular disease in the general population and elderly subjects are at high risk of elevated homocysteine because of an impaired vitamin status. The aim of the present study was to determine the independent and interactive association of adequate folate and cobalamin (intake and serum levels) with tHcy in elderly subjects who were not taking vitamin supplementation.
  
  
  METHODS
  Cross-sectional analysis of a sample of 140 elderly recruited from seven nursing homes in Asturias (Northern Spain). Dietary intake was assessed by a food frequency questionnaire, and serum folate, cobalamin, and tHcy were determined in fasting blood samples.
  
  
  RESULTS
  Mean tHcy concentration was 13.3 micromol/L (upper quartile of tHcy >16.0 micromol/L) and was inversely correlated with serum folate. Subjects with an adequate intake or serum levels of both folate and B12 were at a reduced risk of being in the highest quartile of tHcy. In both cases, the reduction of high tHcy (upper quartile) risk was found to be greater than expected when subjects with high levels of both vitamins were considered together.
  
  
  CONCLUSIONS
  Adequate folate and cobalamin (both intake and serum levels) act synergistically to decrease the risk of high total plasma homocysteine levels in this elderly population.
authors.affiliation: Departamento de Biología Funcional, Area de Fisiología, Facultad de Medicina, Universidad de Oviedo, 33006, Oviedo, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Huerta
authors.forename: Sonia
authors.initials: S
authors.lastname: González
authors.forename: Elena
authors.initials: E
authors.lastname: Vigil
authors.forename: Mercedes
authors.initials: M
authors.lastname: Prada
authors.forename: Julia
authors.initials: J
authors.lastname: San Martín
authors.forename: Serafina
authors.initials: S
authors.lastname: Fernández
authors.forename: Angeles M
authors.initials: AM
authors.lastname: Patterson
authors.forename: Cristina
authors.initials: C
authors.lastname: Lasheras
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet; D004357:Drug Synergism; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D006707:Homes for the Aged; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012307:Risk Factors; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000097:blood; D014803:Vitamin B Complex / Q000097:blood*
chemical_list: D006710:Homocysteine; D014803:Vitamin B Complex; D005492:Folic Acid; D014805:Vitamin B 12