[ role of homocysteine in health and disease]

High plasma homocysteine is identified as an important risk factor for cardiovascular disease. Epidemiological studies have shown that increased plasma homocysteine is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease. Homocysteine may have an effect on atherosclerosis by damaging the inner lining of arteries and promoting blood clots. Folic acid and other B group vitamins help break down homocysteine in the body and fortification of foods reduces the average homocysteine level in the population. Low blood levels of folate are also linked with a higher risk of fatal coronary heart disease and stroke. Homocysteine levels are strongly influenced via diet, as well as via genetic factors. Many common genetic disorders and problems [such as vitamin deficiency] adversely affect the metabolism of homocysteine. Common causes of a high homocysteine level include dietary of folate and B group vitamins, hypothyroidism, kidney disease, psoriasis, and some medicines. Clinical trials to have not provided consistent evidence that lowering homocysteine levels reduce strokes, heart attacks and other cardiovascular events; notwithstanding it is recommended to lower a high homocysteine level because it is a risk factor for heart disease, Homocysteine abnormalities also contribute to birth defects and dementia and folic acid supplementation in the pre-conceptual period is effective in preventing recurrent and primary neural tube defects

Determinants of total plasma homocysteine concentration in healthy Iranian adults: the Tehran homocysteine survey [2003-2004]

Elevated total plasma Homocysteine, is an independent risk factor for cardiovascular disease. Folate and vitamin B12 have not only a protective effect on cardiovascular disease but also an essential effect on total Homocysteine concentrations [tHcy]. This survey has been conducted to evaluate the determinants of tHcy in 1191 healthy Iranian adults. This study which was a part of the Cardiovascular Risk Factors Survey in the Population Lab Region has been designed and conducted based on MONICA/WHO project. A total of 1191 people have been recruited and assessed on serum Homocysteine, Folic acid and vitamin B12, triglycerides, cholesterol, HDL-C, LDL-C, FBS, BMI, BP and smoking, with interview, questionnaires, examination and blood sampling. Blood samples were analyzed according to standard methods. The variables were assessed in 1191 participants include 416 men [34.9%] and 775 women [65.1%]. Prevalence of hyperhomocysteinemia was correlated significantly with male sex and aging. Hcy levels were inversely related to serum Folate and vitamin B12 concentrations. After further adjustments, we detected a positive correlation between tHcy and age, male sex, smoking and BMI, and a negative one with LDL-C and diabetes. Although there was a correlation between tHcy and blood pressure, after age, sex, BMI and smoking adjustment, it just remained significant in women and with systolic blood pressure. We found that dietary and lifestyle parameters such as Folate intake and smoking habit are the main determinants of distribution of plasma Homocysteine in an apparently healthy population. We assumed that lifestyle changes could have considerable subsequences in public health. Our findings confirm the potential advantages of dietary improvements and increased intake of nutrients along with smoking cessation in order to prevent cardiovascular diseases in high-risk patients

[Cardiovascular screening of children and parents in high-risk families]

Background: cardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families

Methods: the middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants

Results: prevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families

Conclusion: cardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood