title: Genetic and environmental influences on total plasma homocysteine and its role in coronary artery disease risk.
abstract: BACKGROUND
  Elevated levels of total plasma homocysteine are a risk factor for atherosclerotic disease.
  
  
  OBJECTIVE
  The rationale behind this study is to explore the correlation between degree and site of coronary lesion and hyperhomocysteinemia in Lebanese CAD patients and assess environmental and genetic factors for elevated levels of total plasma homocysteine.
  
  
  METHODS
  A total of 2644 patients were analyzed for traditional CAD risk factors. Logistic regression was performed to determine the association of hyperhomocysteinemia with degree and site of coronary lesions controlling for risk factors. Environmental and genetic factors for hyperhomocysteinemia were analyzed by logistic regression using a candidate gene approach.
  
  
  RESULTS
  Traditional risk factors were correlated with stenosis. Hyperhomocysteinemia associated with increased risk of overall stenosis, and risk of mild and severe occlusion in major arteries. Hyperhomocysteinemia and hypertension were highly correlated suggesting that hyperhomocysteinemia acts as a hypertensive agent leading to CAD. Diuretics and genetic polymorphisms in MTHFR and SLCO1B1 were associated with hyperhomocysteinemia.
  
  
  CONCLUSIONS
  Hyperhomocysteinemia is a medical indicator of specific vessel stenosis in the Lebanese population. Hypertension is a major link between hyperhomocysteinemia and CAD occurrence. Genetic polymorphisms and diuretics' intake explain partly elevated homocysteine levels. This study has important implications in CAD risk prediction.
authors.affiliation: Lebanese American University, School of Medicine, Beirut 1102 2801, Lebanon.
authors.forename: Michella
authors.initials: M
authors.lastname: Ghassibe-Sabbagh
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Platt
authors.forename: Sonia
authors.initials: S
authors.lastname: Youhanna
authors.forename: Antoine B
authors.initials: AB
authors.lastname: Abchee
authors.forename: Krista
authors.initials: K
authors.lastname: Stewart
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Badro
authors.forename: Marc
authors.initials: M
authors.lastname: Haber
authors.forename: Angelique K
authors.initials: AK
authors.lastname: Salloum
authors.forename: Bouchra
authors.initials: B
authors.lastname: Douaihy
authors.forename: Hamid
authors.initials: H
authors.lastname: el Bayeh
authors.forename: Raed
authors.initials: R
authors.lastname: Othman
authors.forename: Nabil
authors.initials: N
authors.lastname: Shasha
authors.forename: Samer
authors.initials: S
authors.lastname: Kibbani
authors.forename: Elie
authors.initials: E
authors.lastname: Chammas
authors.forename: Aline
authors.initials: A
authors.lastname: Milane
authors.forename: Rita
authors.initials: R
authors.lastname: Nemr
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kamatani
authors.forename: Jörg
authors.initials: J
authors.lastname: Hager
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Cazier
authors.forename: Dominique
authors.initials: D
authors.lastname: Gauguier
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Zalloua
mesh_terms: D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000209:etiology; D003324:Coronary Artery Disease / Q000209:etiology / Q000235:genetics*; D004232:Diuretics / Q000009:adverse effects; D005260:Female; D059647:Gene-Environment Interaction; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000235:genetics*; D006973:Hypertension / Q000150:complications; D007861:Lebanon; D027381:Liver-Specific Organic Anion Transporter 1; D016015:Logistic Models; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D027361:Organic Anion Transporters / Q000235:genetics; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D004232:Diuretics; D027381:Liver-Specific Organic Anion Transporter 1; D027361:Organic Anion Transporters; C503999:SLCO1B1 protein, human; D006710:Homocysteine; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)