RELATION OF SERUM HOMOCYSTEINE AND LIPOPROTEIN(A) CONCENTRATIONS TO ATHEROSCLEROTIC DISEASE IN A PROSPECTIVE FINNISH POPULATION-BASED STUDY

The relation of serum total homocysteine and lipoprotein(a) (Lp(a)) wi th the incidence of atherosclerotic disease was investigated among 742 4 men and women aged. 40-64 years free of atherosclerotic disease at b aseline in 1977. During the 9-year follow-up, 134 male and 131 female cases with either myocardial infarction or stroke were identified. For each case a control subject was selected belonging to the same sex an d 5-year age group. Serum samples collected in 1977 were stored at -20 degrees C and analyzed in 1991. The mean serum homocysteine concentra tion of male cases and controls was 9.99 mu mol/l and 9.82 mu mol/l at baseline and that of female cases and controls 9.58 mu mol/l and 9.24 mu mol/l, respectively. The median serum Lp(a) concentration of male cases and controls was 73 mg/l and 108 mg/l and that of female cases a nd controls 113 mg/l and 91 mg/l, respectively. The differences betwee n cases and controls were not statistically significant. There was als o no significant association between either homocysteine or Lp(a) and atherosclerotic disease, myocardial infarction or stroke in logistic r egression analyses. The odds ratios varied from 1.00 to 1.26 for homoc ysteine and from 0.81 to 1.06 for Lp(a). The results of this prospecti ve population-based study do not support the hypotheses that serum hom ocysteine or Lp(a) are risk factors for atherosclerotic disease. The l ack of association between serum homocysteine and atherosclerotic dise ase may be due to the exceptionally low gene frequency predisposing to homocysteinemia in Finland.