title: Marked gender difference in plasma total homocysteine concentrations in indian adults with low vitamin B₁₂.
abstract: BACKGROUND
  Plasma total homocysteine (tHcy) is higher in men than women.
  
  
  OBJECTIVE
  To explore the gender differences in tHcy in relation to determinants of one-carbon metabolism in Indian people with low B₁₂ and adequate folate.
  
  
  METHODS
  The study took place in rural and urban areas of Pune, India.
  
  
  METHODS
  Participants were 441 men from the cross-sectional Coronary Risk of Insulin Sensitivity in Indian Subjects study (CRISIS) and premenopausal wives of 146 men (median ages 38 and 34 years, respectively).
  
  
  METHODS
  Gender difference in fasting tHcy in relation to plasma albumin and creatinine concentrations, lifestyle factors, diet and lean mass, plasma B₁₂ and red cell folate (RCF) was assessed.
  
  
  RESULTS
  Prevalence of high tHcy (> 15 µmol/L, median 14.4 µM) was 40 %, low B12 (< 150 pmol/L, 114 pmol/L) 66 %, and low RCF (< 283 nmol/L, 525 nmol/L) 8 %. Men had higher (1.8x) plasma tHcy concentrations (16.2 µmol/L) than women (9.5 µmol/L). Only 50 % of the gender difference was explained by age, lean mass, B₁₂, and RCF. The difference remained after controlling for other explanatory variables. Women with a tHcy of 9.3 µM had the same B₁₂ concentration (129 pmol/L) as men with a tHcy of 15 µM; and for a tHcy of 10.0 µmol/L women had the same RCF concentration (533 nmol/L) as men with a tHcy of 15 µmol/L.
  
  
  CONCLUSIONS
  Adult Indian women have markedly lower tHcy concentrations compared to men. This suggests a lower threshold for supplementation to improve reproductive and cardiovascular outcomes.
authors.affiliation: Diabetes Unit, King Edward Memorial Hospital Research Centre, Pune, India.
authors.forename: Sadanand
authors.initials: S
authors.lastname: Naik
authors.forename: Charudatta
authors.initials: C
authors.lastname: Joglekar
authors.forename: Dattatray
authors.initials: D
authors.lastname: Bhat
authors.forename: Himangi
authors.initials: H
authors.lastname: Lubree
authors.forename: Sonali
authors.initials: S
authors.lastname: Rege
authors.forename: Kondiba
authors.initials: K
authors.lastname: Raut
authors.forename: Prachi
authors.initials: P
authors.lastname: Katre
authors.forename: Elaine
authors.initials: E
authors.lastname: Rush
authors.forename: Chittaranjan
authors.initials: C
authors.lastname: Yajnik
mesh_terms: D000328:Adult; D000367:Age Factors; D001823:Body Composition; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D005492:Folic Acid / Q000097:blood; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology; D007194:India / Q000453:epidemiology; D008297:Male; D012737:Sex Factors; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood*
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12