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(Stroke. 2002;33:2351.)
© 2002 American Heart Association, Inc.

Original Contributions

Moderately Elevated Plasma Homocysteine, Methylenetetrahydrofolate Reductase Genotype, and Risk for Stroke, Vascular Dementia, and Alzheimer Disease in Northern Ireland

Stephen P. McIlroy, PhD; Kevin B. Dynan, MD; John T. Lawson, FRCR; Christopher C. Patterson, PhD A. Peter Passmore, MD

From the Departments of Geriatric Medicine (S.P.M., K.B.D., A.P.P.) and Epidemiology and Public Health (C.C.P), Queen’s University Belfast, and Department of Radiology, Belfast City Hospital Trust Group (J.T.L.), Belfast, Northern Ireland.

Correspondence to Dr S.P. McIlroy, Department of Geriatric Medicine, Queen’s University Belfast, Whitla Medical Building, 97 Lisburn Rd, Belfast BT9 7BL, Northern Ireland. E-mail s.mcilroy{at}qub.ac.uk

Background and Purpose— Elevated plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease. Variation in the levels of this amino acid has been shown to be due to nutritional status and methylenetetrahydrofolate reductase (MTHFR) genotype.

Methods— Under a case-control design we compared fasting levels of homocysteine and MTHFR genotypes in groups of subjects consisting of stroke, vascular dementia (VaD), and Alzheimer disease patients and normal controls from Northern Ireland.

Results— A significant increase in plasma homocysteine was observed in all 3 disease groups compared with controls. This remained significant after allowance for confounding factors (age, sex, hypertension, cholesterol, smoking, creatinine, and nutritional measures). MTHFR genotype was not found to influence homocysteine levels, although the T allele was found to increase risk for VaD and perhaps dementia after stroke.

Conclusions— We report that moderately high plasma levels of homocysteine are associated with stroke, VaD, and Alzheimer disease. This is not due to vascular risk factors, nutritional status, or MTHFR genotype.

Key Words: cerebrovascular disorders • dementia • genetics • homocyst(e)ine

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