Is ischemic stroke risk related to folate status or other nutrients correlated with folate intake?
OBJECTIVE
Folate status was inversely associated with plasma homocysteine concentration, a potential risk factor of cardiovascular disease. However, it is uncertain whether folate is causally associated with risk of ischemic stroke (IS). We aimed to examine the association between IS incidence and folate intake, biochemical folate status, and folate associated nutrients.


METHODS
Information on baseline characteristics and food frequency questionnaire was collected in 1990 to 1993 and included for analyses data from 1772 adults over 40 years, who were free of stroke and cancer at baseline from the CardioVascular Disease risk FACtor Two-township Study. Multivariate Cox proportional hazard model was used to relate baseline nutrient status with IS event.


RESULTS
Over an average of 10.6 years of follow-up, 132 incident IS events were documented. Low folate intake (1st and 2nd quartiles) was significantly and independently associated with increased IS risk (HR=1.61; 95% CI: 1.04 to 2.48 and HR=1.82; 95% CI: 1.20 to 2.76) compared with those in the 3rd and 4th quartile combined, whereas no association was observed for plasma folate concentration. On the other hand, several nutrients correlated with dietary folate: vitamin B2, potassium, iron, vitamin A of plant origin, calcium were also associated with IS risk in an inverse linear manner with HR ranging from 1.5 to 1.9 for the first quartile.


CONCLUSIONS
The protective association of dietary folate on IS risk may be in part through that of other correlated nutrients or other dietary components.
Weng
Lu-Chen
LC
Institute of Biomedical Sciences, Academia Sinica, National Taiwan University, Taipei, Taiwan.
Yeh
Wen-Ting
WT
Bai
Chyi-Huey
CH
Chen
Hsin-Jen
HJ
Chuang
Shao-Yuan
SY
Chang
Hsing-Yi
HY
Lin
Bi-Fong
BF
Chen
Kuan-Ju
KJ
Pan
Wen-Harn
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001798:Blood Proteins / Q000032:analysis; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005492:Folic Acid / Q000502:physiology*; D005494:Folic Acid Deficiency / Q000150:complications / Q000453:epidemiology*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D008019:Life Style; D008297:Male; D018977:Micronutrients / Q000097:blood; D008875:Middle Aged; D009751:Nutritional Requirements; D012307:Risk Factors; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
D001798:Blood Proteins; D018977:Micronutrients; D006710:Homocysteine; D005492:Folic Acid