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Clarke, M.D., from the University of Oxford in the United Kingdom, and colleagues performed a meta-analysis of 19 unpublished datasets (48,175 coronary heart disease cases and 67,961 controls) and 86 published datasets (28,617 cases and 41,857 controls).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Considering the unpublished studies, the researchers found that, comparing TT versus CC homozygotes, the case-control odds ratio for heart disease was 1.02 (95 percent confidence interval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"The CI for the overall result from large unpublished datasets shows lifelong moderate homocysteine elevation has little or no effect on coronary heart disease," Clarke and colleagues conclude.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Elevated homocysteine levels are not associated with a greater risk of coronary heart disease when considering unpublished data, suggesting publication bias, according to a study available online Feb. 21 in PLoS Medicine.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
Trulicity (dulaglutide) is a once-weekly subcutaneous injection to improve glycemic control, along with diet and exercise, in adults with type 2 diabetes.
The rate of major adverse cardiovascular events is higher in patients with diabetes mellitus and multivessel coronary artery disease treated with insulin versus those not treated with insulin, according to a study published in the Sept. 23 issue of the Journal of the American College of Cardiology.
For patients undergoing lumbar spine surgery, Clostridium difficile infection is associated with longer, more expensive hospital stays, and increased mortality, according to a study published in the Sept. 1 issue of Spine.
Patients diagnosed with type 1 diabetes have long known the benefits of ease and convenience that comes with using an insulin pump instead of relying on multiple daily insulin injections to control their condition. A recent study has shown that using a pump is also associated with positive effects on long-term cardiovascular risk and mortality.
Researchers at the Children’s Hospital of Philadelphia recently released the results of a study that identified a protein that could play a key role in a variety of diseases.
Scientists have uncovered a key factor to explain why antibiotic-resistant bacteria can thrive in a hospital setting. These findings have published in the Sept. 17 issue of Science Translational Medicine.
Use of electronic medical record systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.
More Reading