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Test Utilization and Outcomes |
1
Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford, OX2 6HE, UK.
2
Department of Clinical Gerontology, Addenbrooke's
Hospital, Cambridge, CB2 2QQ, UK.
3
Department of Pharmacology, University of Bergen,
Armauer Hansens Hus, 5021 Bergen, Norway.
4
Medical Statistics Unit, London School of Hygiene &
Tropical Medicine, Keppel St., London, UK.
a Author for correspondence. Fax (44)1865-558817; e-mail robert.clarke{at}ctsu.ox.ac.uk.
The variability of plasma total homocysteine (tHcy) was examined in 96 individuals over a 1-yr period. Blood tHcy concentrations varied from 7.1 µmol/L in the bottom quintile to 14.5 µmol/L in the top quintile. The mean tHcy was 10.4 µmol/L, the between-person SD was 2.5 µmol/L, and the within-person SD was 0.93 µmol/L. There was little seasonal variation, and the reliability coefficient was 0.88. Mean tHcy concentrations were inversely related to mean plasma folate (r = -0.36) and vitamin B12 (r = -0.35) concentrations. Median tHcy concentrations were ~1 µmol/L higher in men than in women and in older (70 to 74 years) than in younger (65 to 69 years) individuals and higher in those with the TT and CT genotypes for the methylenetetrahydrofolate reductase polymorphism than in those with the CC genotype (10.7 and 10.6 vs 9.6 µmol/L). Epidemiological studies based on single tHcy measurements may underestimate the magnitude of any risk associations with disease by 10–15%.
The following articles in journals at HighWire Press have cited this article:
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  R. R. McLean, P. F. Jacques, J. Selhub, L. Fredman, K. L. Tucker, E. J. Samelson, D. P. Kiel, L. A. Cupples, and M. T. Hannan Plasma B Vitamins, Homocysteine, and Their Relation with Bone Loss and Hip Fracture in Elderly Men and Women J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2206 - 2212. [Abstract] [Full Text] [PDF]
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H. Refsum, A. D. Smith, P. M. Ueland, E. Nexo, R. Clarke, J. McPartlin, C. Johnston, F. Engbaek, J. Schneede, C. McPartlin, et al. Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion Clin. Chem., January 1, 2004; 50(1): 3 - 32. [Abstract] [Full Text] [PDF]
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D. S. Wald, L. Bishop, N. J. Wald, M. Law, E. Hennessy, D. Weir, J. McPartlin, and J. Scott Randomized Trial of Folic Acid Supplementation and Serum Homocysteine Levels Arch Intern Med, March 12, 2001; 161(5): 695 - 700. [Abstract] [Full Text] [PDF]
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K. Rasmussen, J. Moller, and M. Lyngbak Within-Person Variation of Plasma Homocysteine and Effects of Posture and Tourniquet Application Clin. Chem., October 1, 1999; 45(10): 1850 - 1855. [Abstract] [Full Text] [PDF]
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J. Moller, K. Rasmussen, and L. Christensen External Quality Assessment of Methylmalonic Acid and Total Homocysteine Clin. Chem., September 1, 1999; 45(9): 1536 - 1542. [Abstract] [Full Text] [PDF]
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P. Thirup and S. Ekelund Day-to-Day, Postprandial, and Orthostatic Variation of Total Plasma Homocysteine Clin. Chem., August 1, 1999; 45(8): 1280 - 1283. [Full Text] [PDF]
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 R. Clarke, A. D. Smith, K. A. Jobst, H. Refsum, L. Sutton, and P. M. Ueland Folate, Vitamin B12, and Serum Total Homocysteine Levels in Confirmed Alzheimer Disease Arch Neurol, November 1, 1998; 55(11): 1449 - 1455. [Abstract] [Full Text] [PDF]
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