Homocysteine, vitamins and gene mutations in peripheral arterial disease

A case-control study was undertaken involving 51 consecutive patients with peripheral artery obstructive disease (PAOD) scheduled for angioplasty. Blo od samples of these patients were analysed for plasma homocysteine (tHcy) a nd levels of vitamin B-12 and folate, and the MTHFR gene was assessed for m utation. Patients were compared with age- and sex-matched controls who did not present with cardiovascular risk factors. Mean tHcy did not differ betw een cases and controls (13.3 +/- 5.7 and 12.6 +/- 4.9 mu mol/l, P=0.49). Mo re patients were above the 95th percentile as determined from the data in t he control group with an odds ratio (OR) that almost reached statistical si gnificance [OR, 2.8; 95% confidence interval (CI), 0.9-8.7], but on separat e analyses only female patients slowed higher tHcy than female controls (15 .6 versus 12.0 mu mol/l, P=0.05), with an odds ratio for tHcy above the 95t h percentile of 10.5 (95% CI, 1.1-96.6). The TT genotype of the MTHFR gene was found in 24% of the patients and in 12% of the controls (OR, 2.3; 95% C I, 0.8-6.7). Our findings point to a modest association between tHcy and PA OD, with a difference between cases and controls restricted to the highest percentile in female patients. A weak but not significant association was a lso found for the TT genotype of the MTHFR gene. (C) 2001 Lippincott Willia ms & Wilkins.