HYPERHOMOCYST(E)INAEMIA - AN INDEPENDENT RISK FACTOR FOR INTERMITTENTCLAUDICATION

The aim of this study was to test the question of hyperhomocyst(e)inae mia as a risk factor for intermittent claudication (IC) independent of other important risk factors for peripheral atherosclerotic disease, such as smoking, hypertension, diabetes mellitus, hypercholesterolaemi a, hypertriglyceridaemia, low levels of high-density-lipoprotein (HDL) cholesterol and age. The study population was recruited from an epide miological study in Linkoping County, Sweden. where all middle-aged me n (n = 15253, 45-69 years of age) were screened for IC. Seventy-eight subjects with verified IC and 98 healthy sex- and age-matched controls were randomly selected. Plasma levels of homocyst(e)ine (including th e sum of free and bound forms of homocysteine and their disulphide oxi dation products, homocystine, and homocysteine-cysteine mixed disulphi de) were significantly higher (16.74 +/- 5.45-mu-mol l-1, mean value /- SD, P = 0.0002) in IC subjects than in controls (13.80 +/- 3.21-mu- mol l-1), with 23 % of the claudicants above the 95th percentile for c ontrols. Stepwise logistic regression analysis revealed that the diffe rence in plasma homocyst(e)ine was independent of the other above-ment ioned risk factors. Moreover, the elevation of plasma homocyst(e)ine i n claudicants was mainly confined to subjects with serum folate levels of less-than-or-equal-to 11.0 nmol l-1. The results suggest that foli c acid supplementation should be tried in IC subjects with hyperhomocy st(e)inaemia.