title: The association between lifestyle-related factors and plasma homocysteine levels in healthy individuals from the "ATTICA" Study.
abstract: OBJECTIVE
  The aim of this work was to investigate the associations between homocysteine levels and several lifestyle-related factors, in a population-based sample of Greek adults.
  
  
  METHODS
  During 2001-2002, we randomly enrolled 1128 men and 1154 women, from Athens area. The sampling was stratified by the age-gender distribution of the underlying population. Among several demographic, lifestyle, clinical and biochemical factors, we measured plasma total homocysteine levels. For the present analysis, we excluded people who had a history of cardiovascular disease.
  
  
  RESULTS
  Homocysteine values were higher in men as compared to women (14.5+/-6 vs. 10.8+/-3.5 micromol/l, p<0.001). Twenty-five percent of men and 15% of women had plasma homocysteine levels >14 micromol/l. Postmenopausal women had higher homocysteine levels (12.0+/-5.2 vs. 9.9+/-2.9 micromol/l, p<0.001). The lifestyle factors most strongly associated with plasma total homocysteine were number of cigarettes smoked (r=0.12, p=0.004), fruits (r=-0.12, p=0.006) and vegetables consumption (r=-0.15, p=0.02), alcohol (r=0.11, p=0.04) and coffee drinking (r=0.10, p=0.03). Additionally, aerobic exercise was related with lower homocysteine levels as compared to anaerobic or sedentary life (11.0+/-2.6 vs. 12.4+/-2.5 vs. 12.5+/-2.3 micromol/l, respectively, p=0.04). Multivariate analysis after adjusting for several potential confounders confirmed the previous associations. No relationship was observed of homocysteine with the Mediterranean diet score (r=0.02, p=0.85).
  
  
  CONCLUSIONS
  Several lifestyle-related factors were associated with homocysteine levels. Identifying and understanding modifiable factors related to homocysteine, a possible risk factor for vascular disease, might be especially important for the public health.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. d.b.panagiotakos@usa.net
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Akis
authors.initials: A
authors.lastname: Zeimbekis
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D003069:Coffee; D004032:Diet; D004305:Dose-Response Relationship, Drug; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012907:Smoking
chemical_list: D003069:Coffee; D006710:Homocysteine