title: Association of increased levels of homocysteine and peripheral arterial disease in a Japanese-Brazilian population.
abstract: OBJECTIVE
  Our aim was to evaluate the possible association between homocysteine levels and peripheral arterial disease (PAD) in a population-based study of Japanese-Brazilians.
  
  
  METHODS
  This cross-sectional study was derived from a population-based survey on the prevalence of diabetes and associated diseases conducted in Japanese-Brazilians. A total of 1330 male and female subjects aged>or=30 years were submitted to clinical examination and laboratory procedures including homocysteine measurement. The ankle-brachial index (ABI) was calculated; subjects with ABI values <0.9 were diagnosed with PAD. The evaluable population included 1008 subjects. Logistic regression was used taking PAD as the dependent variable.
  
  
  RESULTS
  Mean age of the population was 56.5 years and overall prevalence of PAD was 20%. A worse cardiovascular profile was found in male patients, including significantly higher homocysteine levels (11.9+/-1.8 vs. 9.1+/-1.1micromol/L, p<0.001). Men with PAD had higher prevalence rates of hyperhomocysteinemia compared to women (22.7% vs 7.6%). Univariate analysis showed an odds ratio of hyperhomocysteinemia for PAD of 1.51 [1.02-2.25] in men and 1.69 [1.06-2.68] in women. After adjustment for other cardiovascular risk factors, higher levels of homocysteine were only significantly related to PAD in men.
  
  
  CONCLUSIONS
  In a Japanese-Brazilian population, elevated levels of homocysteine are associated with PAD in men. Prospective studies are necessary to confirm this finding.
authors.affiliation: Post-Graduation Course on Cardiac, Vascular and Thoracic Surgery, Surgery Department, Federal University of Sao Paulo, Sao Paulo, Brazil. lgarofolo@ig.com.br
authors.forename: L
authors.initials: L
authors.lastname: Garofolo
authors.forename: N
authors.initials: N
authors.lastname: Barros
authors.forename: F
authors.initials: F
authors.lastname: Miranda
authors.forename: V
authors.initials: V
authors.lastname: D'Almeida
authors.forename: L C
authors.initials: LC
authors.lastname: Cardien
authors.forename: S R
authors.initials: SR
authors.lastname: Ferreira
mesh_terms: D017677:Age Distribution; D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood / Q000150:complications / Q000208:ethnology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications / Q000208:ethnology; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000208:ethnology; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000208:ethnology; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000208:ethnology; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000208:ethnology / Q000209:etiology; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D014280:Triglycerides; D006710:Homocysteine; D002784:Cholesterol