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

Monica L. Bertoia, Jennifer K. Pai, John P. Cooke, Michel M. Joosten, Murray A. Mittleman, Eric B. Rimm, Kenneth J. Mukamal

Research output: Contribution to journalArticle

28 Scopus citations

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 250μg 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.

Original languageEnglish (US)
Pages (from-to)94-101
Number of pages8
JournalAtherosclerosis
Volume235
Issue number1
DOIs
StatePublished - Jul 2014

Keywords

  • Betaine
  • Choline
  • Folate
  • Homocysteine
  • Peripheral artery disease
  • Riboflavin
  • Vitamin B12
  • Vitamin B6

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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