title: Homocysteine, vitamin B12 and folate levels in premature coronary artery disease.
abstract: BACKGROUND
  Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD.
  
  
  METHODS
  We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran.
  
  
  RESULTS
  After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 +/- 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia.
  
  
  CONCLUSIONS
  We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (below 45 years old)--especially in men--and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.
authors.affiliation: Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. sadeghian15@yahoo.com
authors.forename: Saeed
authors.initials: S
authors.lastname: Sadeghian
authors.forename: Faramarz
authors.initials: F
authors.lastname: Fallahi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Salarifar
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Davoodi
authors.forename: Mehran
authors.initials: M
authors.lastname: Mahmoodian
authors.forename: Nader
authors.initials: N
authors.lastname: Fallah
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Darvish
authors.forename: Abbasali
authors.initials: A
authors.lastname: Karimi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005494:Folic Acid Deficiency / Q000150:complications / Q000453:epidemiology; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000209:etiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012727:Sex Characteristics; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000453:epidemiology
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12