This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Adachi, H. Articles by Imaizumi, T. Search for Related Content PubMed PubMed Citation Articles by Adachi, H. Articles by Imaizumi, T. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Carotid Artery Disease Related Collections Risk Factors Carotid Stenosis Epidemiology

(Stroke. 2002;33:2177.)
© 2002 American Heart Association, Inc.

Original Contributions

Plasma Homocysteine Levels and Atherosclerosis in Japan

Epidemiological Study by Use of Carotid Ultrasonography

Hisashi Adachi, MD, PhD; Yuji Hirai, MD; Yoshihisa Fujiura, MD; Hidehiro Matsuoka, MD, PhD; Akira Satoh, MD Tsutomu Imaizumi, MD, PhD

From the Third Department of Internal Medicine and Cardiovascular Research Institute, Kurume University School of Medicine, Kurume, Japan.

Correspondence to Hisashi Adachi, MD, PhD, Third Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan. E-mail hadac{at}med.kurume-u.ac.jp

Background and Purpose— We examined whether hyperhomocysteinemia is an independent risk factor for increased carotid artery intimal-medial wall thickness (IMT) in a large, randomly selected community in Japan where the dietary habit is different and the incidence of coronary artery disease is lower compared with those of western countries.

Methods— In 1111 cases (452 men, 659 women) aged 63±10 years old (range, 40 to 94 years) recruited from a population-based survey performed in 1999, we measured fasting plasma total homocysteine levels and performed bilateral carotid B-mode ultrasound. The participants underwent measurements of other blood chemistries (total cholesterol, HDL cholesterol, glycosylated hemoglobin A_1c, and creatinine).

Results— For the total population, the mean total homocysteine level was 10.9 µmol/L. Total homocysteine levels were higher in men than in women and increased with aging. With multiple linear regression analysis after adjustments for age and sex, the most powerful determinant of total homocysteine levels was serum creatinine (P<0.001). With multiple stepwise regression analysis after adjustments for age, sex, and other confounding factors, total homocysteine was significantly (P<0.05) related to IMT. Furthermore, when mean values of IMT adjusted for age, sex, and other related factors were analyzed across total homocysteine quartiles, IMT (P<0.05) showed a significant trend as total homocysteine level increased.

Conclusions— Plasma total homocysteine levels in Japan are similar to those reported in western countries. Mild hyperhomocysteinemia is an independent risk factor for increased carotid artery wall thickness in Japan as well.

Key Words: atherosclerosis • epidemiology • homocysteine • intima-media thickness

This article has been cited by other articles:

				S. Dayal, R. N. Rodionov, E. Arning, T. Bottiglieri, M. Kimoto, D. J. Murry, J. P. Cooke, F. M. Faraci, and S. R. Lentz Tissue-specific downregulation of dimethylarginine dimethylaminohydrolase in hyperhomocysteinemia Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H816 - H825. [Abstract] [Full Text] [PDF]

				K. Potter, G. J. Hankey, D. J. Green, J. W. Eikelboom, and L. F. Arnolda Homocysteine or Renal Impairment: Which Is the Real Cardiovascular Risk Factor? Arterioscler. Thromb. Vasc. Biol., June 1, 2008; 28(6): 1158 - 1164. [Abstract] [Full Text] [PDF]

				Wei Hsi Chen, Hung Sheng Lin, Yi Fen Kao, Min Yu Lan, and Jia Shou Liu Hyperhomocysteinemia Relates to the Subtype of Antiphospholipid Antibodies in Non-SLE Patients Clinical and Applied Thrombosis/Hemostasis, October 1, 2007; 13(4): 398 - 403. [Abstract] [PDF]

				K. Nasir, M. Tsai, B. D. Rosen, V. Fernandes, D. A. Bluemke, A. R. Folsom, and J. A.C. Lima Elevated Homocysteine Is Associated With Reduced Regional Left Ventricular Function: The Multi-Ethnic Study of Atherosclerosis Circulation, January 16, 2007; 115(2): 180 - 187. [Abstract] [Full Text] [PDF]

				Y. Aso, K.-i. Okumura, K. Takebayashi, S. Wakabayashi, and T. Inukai Relationships of Plasma Interleukin-18 Concentrations to Hyperhomocysteinemia and Carotid Intimal-Media Wall Thickness in Patients With Type 2 Diabetes Diabetes Care, September 1, 2003; 26(9): 2622 - 2627. [Abstract] [Full Text] [PDF]