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Clarke, M.D., from the University of Oxford in the United Kingdom, and colleagues performed a meta-analysis of 19 unpublished datasets (48,175 coronary heart disease cases and 67,961 controls) and 86 published datasets (28,617 cases and 41,857 controls).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Considering the unpublished studies, the researchers found that, comparing TT versus CC homozygotes, the case-control odds ratio for heart disease was 1.02 (95 percent confidence interval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"The CI for the overall result from large unpublished datasets shows lifelong moderate homocysteine elevation has little or no effect on coronary heart disease," Clarke and colleagues conclude.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Elevated homocysteine levels are not associated with a greater risk of coronary heart disease when considering unpublished data, suggesting publication bias, according to a study available online Feb. 21 in PLoS Medicine.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
CDC Director Thomas Frieden, MD, visited Liberia to assess ongoing efforts to contain the Ebola outbreak and reported that the current prevention and treatment response has unable to stop the virus from spreading.
Self-monitoring with self-titration of antihypertensive medications is associated with lower blood pressure for patients with hypertension at risk for cardiovascular disease, according to a study published in the Aug. 27 issue of the Journal of the American Medical Association.
The nation’s youth, and its smoke-free air need federal protection from vapors from e-cigarettes, according to a set of recommendations released Aug. 25 by the American and Heart Association.
Efforts to combat the ongoing Ebola outbreak in West Africa have gone global as Japan recently announced efforts to provide medical assistance to the cause.
Hospital and health care providers should follow the U.S. Centers for Disease Control and Prevention's recommendations for care of patients with Ebola, according to an ideas and opinions piece published online Aug. 21 in the Annals of Internal Medicine.
Cognitive impairment is associated with an increased risk of subsequent stroke, according to a meta-analysis published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.
Individuals with frequent emergency department visits for acute heart failure syndrome (AHFS) account for the majority of hospitalizations and hospital charges for AHFS, according to a study published online Aug. 19 in Circulation: Cardiovascular Quality and Outcomes.
More Reading