PMID- 11735095
OWN - NLM
STAT- MEDLINE
DCOM- 20020102
LR  - 20220409
IS  - 0026-0495 (Print)
IS  - 0026-0495 (Linking)
VI  - 50
IP  - 12
DP  - 2001 Dec
TI  - Hyperhomocysteinemia and related factors in 600 hospitalized elderly subjects.
PG  - 1466-71
AB  - Hyperhomocysteinemia (HHcy) is a metabolic disorder frequently occurring in the 
      elderly population. Recently several reports have suggested abnormalities in 
      homocysteine (tHcy) metabolism implicating HHcy as a metabolic link in the 
      multifactorial processes characterizing many geriatric illnesses-with special 
      emphasis on atherosclerotic vascular diseases and cognitive impairment. The 
      present study was undertaken in a large sample of elderly hospitalized subjects 
      to determine (1) the prevalence of HHcy, (2) the association of HHcy with 
      vascular and cognitive disorders, and (3) the factors independently predicting 
      Hhcy. Six hundred elderly subjects (264 men and 336 women; mean age, 79 +/- 9 
      years) were randomly chosen from those admitted as inpatients over a period of 3 
      years. In all patients, body mass index (BMI), mid-upper arm muscle area (MUAMA), 
      plasma cholesterol, triglycerides, total proteins, albumin, lymphocyte count, 
      creatinine, homocysteine (fasting and 4 hours after methionine oral load), serum 
      vitamin B(6), vitamin B(12), and folate concentrations were measured. The 
      presence of disease or use of medications known to affect homocysteine plasma 
      levels were also recorded. The mean fasting tHcy level was 16.8 +/- 12 micromol/L 
      in the whole sample, 18.18 +/- 13.25 micromol/L in men, and 15.86 +/- 12.14 
      micromol/L in women (P =.005 men v women). The mean Hcy level 4 hours after 
      methionine load was 37.95 +/- 20.9 in the whole sample. Prevalence of 
      hyperhomocysteinemia (fasting Hcy > or = 15 micromol/L or 4 hours after 
      methionine load > or = 35 micromol/L) was 61% (365/600) (67% in men and 56% in 
      women, P <.05). HHcy was rarely (8%) an isolated disorder; in addition to 
      diabetes (20%), renal failure (48.2%), and malnutrition (20.2%), it was often 
      associated with heart failure (30%), malignancies (20.5%), and the use of 
      diuretics (56%) and anticonvulsant drugs (13%). Plasma homocysteine progressively 
      increases across subjects from those with no diabetes, malnutrition, renal 
      failure, obesity, inflammatory bowel disease, heart failure to those with 1, 2, 
      or more concurrent diseases. Multiple stepwise regression analysis showed that 
      72% of plasma total fasting tHcy variability was explained by age, serum folate, 
      plasma albumin, use of diuretics, and renal function (measured as plasma 
      creatinine clearance). In conclusion, the present study documents that 
      hyperhomocysteinemia, in elderly hospitalized patients is (1) a common finding, 
      (2) frequently associated with vascular and cognitive disorders, and (3) probably 
      a secondary phenomenon in most cases. The major predictor of high plasma 
      homocysteine levels were age, serum folate, plasma albumin, plasma creatinine 
      clearance, and use of diuretic drugs. These variables explain a large proportion 
      of plasma Hcy variability.
CI  - Copyright 2001 by W.B. Saunders Company
FAU - Ventura, P
AU  - Ventura P
AD  - Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, 
      Italy.
FAU - Panini, R
AU  - Panini R
FAU - Verlato, C
AU  - Verlato C
FAU - Scarpetta, G
AU  - Scarpetta G
FAU - Salvioli, G
AU  - Salvioli G
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Metabolism
JT  - Metabolism: clinical and experimental
JID - 0375267
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - AE28F7PNPL (Methionine)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aging
MH  - Dementia/complications
MH  - Diabetes Complications
MH  - Fasting
MH  - Female
MH  - Homocysteine/blood
MH  - Humans
MH  - Hyperhomocysteinemia/complications/*epidemiology
MH  - Inflammatory Bowel Diseases/complications
MH  - Kinetics
MH  - Linear Models
MH  - Male
MH  - Methionine
MH  - Nutrition Disorders/complications
MH  - Odds Ratio
MH  - Renal Insufficiency/complications
MH  - Vascular Diseases/complications
EDAT- 2001/12/06 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/12/06 10:00
PHST- 2001/12/06 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/12/06 10:00 [entrez]
AID - S0026-0495(01)07417-0 [pii]
AID - 10.1053/meta.2001.28079 [doi]
PST - ppublish
SO  - Metabolism. 2001 Dec;50(12):1466-71. doi: 10.1053/meta.2001.28079.