Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jul;235(1):94-101.
doi: 10.1016/j.atherosclerosis.2014.04.010. Epub 2014 Apr 28.

Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease

Monica L Bertoia  1 , Jennifer K Pai  2 , John P Cooke  3 , Michel M Joosten  4 , Murray A Mittleman  5 , Eric B Rimm  6 , Kenneth J Mukamal  7
Affiliations

Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease

Monica L Bertoia et al. Atherosclerosis. 2014 Jul.

Abstract

Objective: Few studies have examined the roles of homocysteine and related nutrients in the development of peripheral artery disease (PAD). We examined the associations between plasma homocysteine, dietary B vitamins, betaine, choline, and supplemental folic acid use and incidence of PAD.

Methods: We used two cohort studies of 72,348 women in the Nurses' Health Study (NHS, 1990-2010) and 44,504 men in the Health Professionals Follow-up Study (HPFS, 1986-2010). We measured plasma homocysteine in nested matched case-control studies of clinically recognized PAD within both cohorts, including 143 PAD cases and 424 controls within the NHS (1990-2010) and 143 PAD cases and 428 controls within the HPFS (1994-2008). We examined the association between diet and risk of incident PAD in the cohorts using a food frequency questionnaire and 790 cases of PAD over 3.1 million person-years of follow-up.

Results: Higher homocysteine levels were positively associated with risk of PAD in men (adjusted IRR 2.17; 95% CI, 1.08-4.38 for tertile 3 vs. 1). There was no evidence of an association in women (adjusted IRR 1.14; 95% CI, 0.61-2.12). Similarly, higher folate intake, including supplements, was inversely associated with risk of PAD in men (adjusted HR 0.90; 95% CI, 0.82-0.98 for each 250 μg increase) but not women (HR 1.01, 95% CI, 0.88-1.15). Intakes of the other B vitamins, betaine, and choline were not consistently associated with risk of PAD in men or women.

Conclusion: Homocysteine levels were positively associated and dietary folate intake was inversely associated with risk of PAD in men but not in women.

Keywords: Betaine; Choline; Folate; Homocysteine; Peripheral artery disease; Riboflavin; Vitamin B12; Vitamin B6.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Splaver A, Lamas GA, Hennekens CH. Homocysteine and cardiovascular disease: biological mechanisms, observational epidemiology, and the need for randomized trials. Am Heart J. 2004 Jul;148(1):34–40. - PubMed
    1. Criqui MH. Peripheral arterial disease--epidemiological aspects. Vasc Med. 2001;6(3 Suppl):3–7. - PubMed
    1. Strain JJ, Dowey L, Ward M, Pentieva K, McNulty H. B-vitamins, homocysteine metabolism and CVD. Proc Nutr Soc. 2004 Nov;63(4):597–603. - PubMed
    1. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049–1057. - PubMed
    1. Clarke R, Halsey J, Lewington S, et al. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med. 2010 Oct 11;170(18):1622–1631. - PubMed

Publication types

MeSH terms