Low serum folate but normal homocysteine levels in patients with atherosclerotic vascular disease and matched healthy controls

Mild hyperhomocysteinemia has been considered a cardiovascular risk factor. However, recent prospective studies have not demonstrated that hyperhomocy steinemia or the underlying genetic defect on methylentetrahydrofolate redu ctase is associated with a higher risk of coronary or peripheral artery dis ease. We compared serum homocysteine, folate, and vitamin B-12 levels of pa tients with coronary and peripheral vascular disease with those of age- and sex-matched healthy individuals. Subjects taking multivitamins, with diabe tes mellitus, or serum creatinine levels over 1.5 mg/dL were excluded from the study. Homocysteine was measured by fluorimetric high-performance liqui d chromatography. Serum folate and vitamin B-12 levels were measured by an ion-capture method. We studied 32 patients with peripheral vascular disease (10 female), aged 69.6 +/- 11 y, 24 age- and sex-matched control subjects, 52 patients with coronary artery disease (7 female), aged 59.5 +/- 10.4 y, and 42 age- and sex-matched control subjects. Serum homocysteine levels we re 11.7 +/- 7.4 and 3.3 +/- 4.5 mu mol/L in vascular patients and in the co ntrol counterparts, respectively (not significant). The levels for coronary patients and the control counterparts were 9.0 +/- 3.9 and 8.6 +/- 3.6 mu mol/L, respectively (not significant). Folate levels were 4.48 +/- 2.42 and 7.14 +/- 4.04 ng/mL in vascular patients and control subjects, respectivel y (P < 0.02); the levels in coronary patients and control counterparts were 5.15 +/- 1.9 and 6.59 +/- 2.49 ng/mL, respectively (P < 0.01). No differen ces in vitamin B-12 or tocopherol levels were observed between patients and control subjects. There were no differences in homocysteine levels, but lo wer serum folate levels were observed when comparing patients with atherosc lerotic vascular disease and healthy control subjects. Nutrition 2000;16:43 4-438. (C)Elsevier Science Inc. 2000.