HCPLive Network

Elevated Homocysteine, Heart Disease Link Questioned

Robert Clarke, M.D., from the University of Oxford in the United Kingdom, and colleagues performed a meta-analysis of 19 unpublished datasets (48,175 coronary heart disease cases and 67,961 controls) and 86 published datasets (28,617 cases and 41,857 controls). Individuals had been genotyped for multiple genetic variants, including the methylene tetrahydrofolate reductase C677T gene variant, with the TT variant associated with elevated homocysteine levels.

Considering the unpublished studies, the researchers found that, comparing TT versus CC homozygotes, the case-control odds ratio for heart disease was 1.02 (95 percent confidence interval [CI], 0.98 to 1.07; P = 0.28) overall, and 1.01 (95 percent CI, 0.95 to 1.07) in unsupplemented low-folate populations. In contrast, for the published studies, the odds ratio was significantly higher, at 1.15. Within the published studies, the odds ratio was 1.12 for the 14 larger studies (13,119 cases) and 1.18 for the 72 smaller studies (15,498 cases).

"The CI for the overall result from large unpublished datasets shows lifelong moderate homocysteine elevation has little or no effect on coronary heart disease," Clarke and colleagues conclude. "The discrepant overall result from previously published studies reflects publication bias or methodological problems."

Several of the authors are employees of Unilever R&D Vlaardingen. One author is an employee of deCode.

Abstract
Full Text (subscription or payment may be required)

Elevated homocysteine levels are not associated with a greater risk of coronary heart disease when considering unpublished data, suggesting publication bias, according to a study available online Feb. 21 in PLoS Medicine.


Copyright © 2012 HealthDay. All rights reserved.


Further Reading
Study results show many patients with chronic obstructive pulmonary disease (COPD) may experience cognitive deterioration that becomes more severe as their COPD worsens.
Resistant hypertension is common among patients with type 2 diabetes, and is strongly associated with microvascular disease.
In this installment, we look at underlying causes of metabolic acidosis, approaches for evaluating patients with suspected metabolic acidosis, and why measurement of the anion gap is of great usefulness in these cases.
For critically ill cardiac surgery patients, fenoldopam does not reduce the need for renal replacement therapy, according to a study published online Sept. 29 in the Journal of the American Medical Association. The study was published to coincide with the annual meeting of the European Society of Intensive Care Medicine, held from Sept. 27 to Oct. 1 in Barcelona, Spain.
Researchers have withdrawn one of the previous Choosing Wisely recommendations from April 2012, according to a report from the American College of Cardiology.
Personal health is a global concern and 3 initiatives are being developed to encourage positive change, according to a report from the American Medical Association.
Fifth American reportedly infected with the Ebola virus will be heading back to this country to receive treatment.
More Reading