Homocyst(e)ine, Diet, and Cardiovascular Diseases: A Statement for Healthcare Professionals From the Nutrition Committee, American Heart Association
Open accessAbstract
Homocysteine and DietHomocysteine is a sulfur-containing amino acid, rapidly oxidized in plasma to the disulfides homocystine and cysteine-homocysteine (Figure 1).Plasma/serum total homocysteine, also termed homocyst(e)ine, is the sum of homocysteine in all 3 components.Figure 2 displays factors involved in the metabolism of homocysteine, including its metabolic relationship to methionine.Although dietary intake of total protein and methionine does not correlate significantly with blood homocyst(e)ine, 1 a single dose of oral methionine (100 mg/kg body weight) can elevate homocyst(e)ine levels, and as described further below, this has been used as a diagnostic test to detect disordered homocyst(e)ine metabolism.Because variable changes in homocyst(e)ine levels have been observed postprandially, 2 it is customary to obtain measurements in the fasting state.Normal levels of fasting plasma homocyst(e)ine are considered to be between 5 and 15 mol/L.Moderate, intermediate, and severe hyperhomocyst(e)inemia refer to concentrations between 16 and 30, between 31 and 100, and Ͼ100 mol/L, respectively.3 Several vitamins function as cofactors and substrates in the metabolism of methionine and homocysteine (Figure 2).Folic acid and cyanocobalamin (vitamin B 12 ) regulate metabolic pathways catalyzed by the enzymes methylenetetrahydrofolate reductase (MTHFR) and methionine synthase, respectively, whereas pyridoxine (vitamin B 6 ) is a cofactor for cystathionine -synthase.A number of studies have shown inverse relationships of blood homocyst(e)ine concentrations with plasma/serum levels of folic acid, vitamin B 6 , and vitamin B 12 .4 -6 Administration of supplemental folic acid in doses between 0.2 and 15 mg/d can lower plasma homocyst(e)ine levels without apparent toxicity.[7][8][9] On the basis of meta-analysis of 12 clinical studies, all but 1 of which was a placebo-References for this article may be found in the on-line version that appears on the American Heart Association Web site (http://www.americanheart.
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Trials of homocysteine-reducing vitamin therapy have been disappointing.
“Trials of homocysteine-reducing vitamin therapy have been disappointing, however.78 -82”
From Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee (2006) · cites this paper as [79]
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Homocysteine and Cardiovascular Disease
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- Authors
- Malinow, M. R., Bostom, A. G., & Krauss, R. M.
- Affiliations
- Oregon Health & Science University (US)
- American Heart Association (US)
- ORCID
- Krauss, Ronald M.
- Venue
- Circulation
- Published
- 1999-01-12
- Volume
- 99
- Issue
- 1
- Pages
- 178-182
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2050878161
- Cited by
- 586
- References
- 1
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 11 · 2022: 7 · 2021: 9 · 2020: 13 · 2019: 17 · 2018: 11 · 2017: 8 · 2016: 11 · 2015: 13 · 2014: 7 · 2013: 17 · 2012: 10
- FWCI
- 35.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Rural Development Administration
- National Institutes of Health (5p01hl018574-26, 5r01hl056908-02)
- National Heart, Lung, and Blood Institute (HL-18574, HL-56908-01A1)
- National Center for Research Resources (RR-00163.)
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- homocysteine, hyperhomocysteinemia, diet, cardiovascular disease, methionine metabolism, folic acid supplementation, vitamin B6, vitamin B12, MTHFR, methionine synthase, cystathionine beta-synthase, homocystine
- MeSH terms
- Cardiovascular Diseases, Cerebrovascular Disorders, Coronary Disease, Diet, Fasting, Female, Homocysteine, Humans, Male, Middle Aged, Vascular Diseases, Vitamins
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