Plasma total homocysteine levels in a healthy Turkish population sample.

OBJECTIVE: The objective of this study is to determine the reference values of homocysteine levels from a sample of healthy native Turks, and the relationship of these levels with gender, age and other risk factors. METHODS AND RESULTS: Plasma homocysteine level was measured in 159 healthy Turkish individuals. Homocysteine levels were determined by the HPLC method and differences between sex and age groupings (20-40 years, 41-60 years, and 61 and older) were compared. Mean homocysteine levels were 8.91 +/- 1.41 micromol/l. The median homocysteine level was 8.35 micromol/l (men 8.80, women 7.0). Homocysteine levels significantly increased with age (r = 0.49) and higher in men than in women in each age group (p < 0.05) (men: 9.51 +/- 1.40; women 7.38 +/- 1.36; p < 0.001). The cut-off point for high homocysteine level is selected to be the value that marks the upper 20% of the control population distribution (12.26 micromol/l). Postmenopausal > 60-year-old women manifested significantly higher increases in total homocysteine concentrations than 20 to 40-year-old premenopausal women. There were no significant correlations between homocysteine and body mass index, glucose, total and lipoprotein lipids, C-reactive protein, creatinine, smoking and alcohol consumption except blood pressure and uric acid. CONCLUSIONS: These data indicate the significance of sex- and age-associated differences of homocysteine levels in native Turkish subjects. Upper reference limits for the plasma total homocysteine concentration increased with age and were higher for men than for women at all ages. Focusing public health initiatives on this issue may reduce the high prevalence of cardiovascular disease in the Turkish population.

Hyperhomocysteinaemia and coronary artery disease in the Turkish population.

OBJECTIVE: Many studies have demonstrated a strong association between elevated plasma total homocysteine (Hcy) levels and vascular disease. The objective of this study was to examine the relation between homocysteine levels and coronary artery disease in Turkish patients. METHODS AND RESULTS: In this study plasma homocysteine levels were measured in control and patient groups. A significant coronary artery lesion was defined as a stenosis of > or = 70% as shown by coronary angiography and determined by on-line quantitative measurements; treatment was by coronary angioplasty. Total plasma Hcy level was measured before the coronary intervention. Plasma homocysteine levels were measured by an HPLC method in patients with a definite diagnosis of coronary artery disease and compared with age- and sex-matched controls. Patients with coronary artery disease had significantly higher mean homocysteine concentrations than control subjects (geometric mean +/- 95% CI: 12.5 +/- 1.1 micromol/l vs. 8.60 +/- 1.07 micromol/l, p<0.001). Eighty-three (59%) members of the patient group and 14 (21%) members of the control group had plasma homocysteine concentrations above the 11.3 micromol/l, which represents the concentration which includes the uppermost quintile of the control group distribution (odds ratio 4.35, 95% CI; 2.1-8.94). CONCLUSION: Results of this study indicate that high plasma levels of homocysteine in Turkish subjects are associated with coronary artery disease. Our data suggest that focusing public health initiatives on this issue may reduce the high prevalence of cardiovascular disease in the Turkish population.