title: Elevated homocysteine is associated with poorer self-perceived physical health in older men: the Health in Men Study.
abstract: OBJECTIVE
  To determine the relationship between high total homocysteine (tHcy) and self-perceived physical health, by investigating the associations between tHcy, the methylenetetrahydrofolate reductase (MTHFR) 677T polymorphism and physical health-related quality of life (HRQOL).
  
  
  METHODS
  We conducted a cross-sectional study using a cohort of 4248 community-dwelling men aged 70-88 years.
  
  
  METHODS
  In addition to clinical determinants of physical health, tHcy was measured by immunoassay, the MTHFR 677T polymorphism was detected by a polymerase chain reaction (PCR)-based method, and physical HRQOL were assessed with the SF-36 Health Survey.
  
  
  RESULTS
  In multiple regression analyses, the odds of being in the lowest quartile of the physical component summary (PCS) scores (i.e. <35) was 1.47 (95% CI 1.21-1.78) for men with high tHcy (≥15 μmol/l), after adjusting for age, smoking, history of hazardous alcohol use, polypharmacy, prevalent falls and weighted Charlson co-morbidity index. When history of hypertension, heart disease, stroke, arthritis and osteoporosis were included in place of the Charlson's index, the result was unchanged (OR 1.45, 95% CI 1.20-1.75). Men with the MTHFR TT homozygosity had significantly higher tHcy concentration than those with the CC genotype (mean difference of 1.38 μmol/l, 95% CI 0.77-1.99). However, there was no apparent association between the MTHFR polymorphism and PCS.
  
  
  CONCLUSIONS
  Elevated tHcy is associated with poorer self-perceived physical health in community-dwelling older men. The results of this study support further longitudinal investigations to assess this relationship prospectively.
authors: Western Australian Centre for Health and Ageing (WACHA), Centre for Medical Research, Perth, WA, Australia. ewong@meddent.uwa.edu.au
authors: Yuen Y E
authors: YY
authors: Wong
authors: Osvaldo P
authors: OP
authors: Almeida
authors: Kieran A
authors: KA
authors: McCaul
authors: Bu B
authors: BB
authors: Yeap
authors: Graeme J
authors: GJ
authors: Hankey
authors: Frank M
authors: FM
authors: van Bockxmeer
authors: Leon
authors: L
authors: Flicker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005838:Genotype; D006304:Health Status; D006710:Homocysteine / Q000097:blood* / Q000235:genetics; D006801:Humans; D020138:Hyperhomocysteinemia / Q000235:genetics / Q000523:psychology*; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D010465:Perception; D011110:Polymorphism, Genetic; D011788:Quality of Life; D012044:Regression Analysis
chemical_list: D006710:Homocysteine; D042965:Methylenetetrahydrofolate Reductase (NADPH2)