Increased plasma homocysteine after menopause

Besides genetic defects in the enzymes involved in homocysteine metabolism and nutritional deficiencies in vitamin cofactors, sex steroid hormones may modulate plasma homocysteine levels. The post-menopausal state has been fo und to be associated with higher plasma homocysteine levels, but data are i nconsistent and studies published so far did not adjust for age, which is a n important confounding factor in studying the effect of menopause. In the present study total plasma homocysteine levels were measured in a meticulou sly selected population in which the contrast in estrogen status between pr e- and postmenopausal women of the same age was maximized. The study compri sed 93 premenopausal and 93 postmenopausal women of similar age (range 43-5 5 years). Women were selected from respondents to a mailed questionnaire on menopause, which was sent to all women aged 40-60 years in the Dutch town of Zoetermeer (n = 12 675). Postmenopausal women who were at least three ye ars after menopause or whose menses had stopped naturally before age 48 wer e age-matched with premenopausal women with regular menses and without meno pausal complaints. Plasma homocysteine levels in the fasting state were rel ated to menopausal status; the age-adjusted geometric mean was 10.7 mu mol/ l in premenopausal and 11.5 mu mol/l in postmenopausal women (difference of 7%, 95% confidence interval 0.3-14%, P = 0.04). Additional adjustment for plasma creatinine, body mass index, smoking habit (yes, no) and alcohol int ake did not influence this difference. The results of this population-based study indicate that plasma homocysteine is affected by menopause. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.