Cited by 1,056Folate and B Vitamins ResearchMetabolism and Genetic DisordersClinical Laboratory Practices and Quality Control

Facts and recommendations about total homocysteine determinations: an expert opinion

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Refsum, Helga, Smith, A David, Ueland, Per M, Nexo, Ebba, Clarke, Robert, McPartlin, Joseph, Johnston, Carole, Engbaek, Frode +3 more·2004·Clinical Chemistry

Abstract

BACKGROUND: Measurement of plasma total homocysteine has become common as new methods have been introduced. A wide range of disorders are associated with increased concentrations of total homocysteine. The purpose of this review is to provide an international expert opinion on the practical aspects of total homocysteine determinations in clinical practice and in the research setting and on the relevance of total homocysteine measurements as diagnostic or screening tests in several target populations. METHODS: Published data available on Medline were used as the basis for the recommendations. Drafts of the recommendations were critically discussed at meetings over a period of 3 years. OUTCOME: This review is divided into two sections: (a) determination of homocysteine (methods and their performance, sample collection and handling, biological determinants, reference intervals, within-person variability, and methionine loading test); and (b) risk assessment and disease diagnosis (homocystinuria, folate and cobalamin deficiencies, cardiovascular disease, renal failure, psychiatric disorders and cognitive impairment, pregnancy complications and birth defects, and screening of elderly and newborns). Each of these subsections concludes with a separate series of recommendations to assist the clinician and the research scientist in making informed decisions. The review concludes with a list of unresolved questions.

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Research works printed but not linked: 6

  1. Refsum H, Fiskerstrand T, Guttormsen AB, Ueland PM. Assess- ment of homocysteine status. J Inherit Metab Dis 1997;20:286 - 94.
  2. Westby C, Alfheim I, Kvam C, Hveem M, Helgesen ÅL, Clarke R. Blood collection using serum separator tubes for homocysteine determination in clinical practice. Proceedings of the 3rd Inter- national Conference on Homocysteine Metabolism, July 1-5, 2001, Sorrento, Italy. Naples, Italy: Edizioni Ziino, 2001:101.
  3. Stabler SP, Allen RH, Savage DG, Lindenbaum J. Clinical spec- trum and diagnosis of cobalamin deficiency. Blood 1990;76: 871-81.
  4. Guttormsen AB, Ueland PM, Nesthus I, Nygård O, Schneede J, Vollset SE, et al. Determinants and vitamin responsiveness of intermediate hyperhomocysteinemia (Ն40 mol/L). The Horda- land Homocysteine Study. J Clin Invest 1996;98:2174 -83.
  5. Ubbink JB. What is a desirable homocysteine level? In: Carmel R, Jacobsen DW, eds. Homocysteine in health and disease. Cam- bridge, UK: Cambridge University Press, 2001:485-90.
  6. McCaddon A, Davies G, Hudson P, Tandy S, Cattell H. Total serum homocysteine in senile dementia of Alzheimer type. Int J Geriatr Psychiatry 1998;13:235-9. 192.

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Authors
Refsum, H., Smith, A. D., Ueland, P. M., Nexo, E., Clarke, R., McPartlin, J., Johnston, C., Engbaek, F., Schneede, J., McPartlin, C., & Scott, J. M.
Affiliations
  • University of Oxford (GB)
  • University of Bergen (NO)
  • Department of Clinical Biochemistry AKH, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
  • Trinity College Dublin (IE)
  • Aarhus University Hospital (DK)
Corresponding author
Refsum, Helga
Venue
Clinical Chemistry
Published
2004-01-01
Volume
50
Issue
1
Pages
3-32
ISSN
  • 0009-9147 (ISSN-L)
  • 1530-8561
OpenAlex
W2165313350
Cited by
1,056
References
298
Citations by year
2026: 19 · 2025: 28 · 2024: 33 · 2023: 23 · 2022: 39 · 2021: 32 · 2020: 35 · 2019: 51 · 2018: 44 · 2017: 46 · 2016: 44 · 2015: 51 · 2014: 51 · 2013: 62 · 2012: 55
FWCI
11.81
Type
journal article
Language
en
Open access
Locations
  • Clinical Chemistry (publishedVersion)
  • PubMed (publishedVersion)
  • Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
Funders
  • U.S. Department of Agriculture
  • University of Oxford
  • Universitetet i Bergen
  • Medical Research Council
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 › Physiology › Clinical Laboratory Practices and Quality Control
Keywords
total homocysteine, sample collection and handling, reference values, within-person variability, methionine loading test, homocystinuria, folate deficiency, vitamin B12 deficiency, cardiovascular disease, renal failure, cognitive impairment, pregnancy complications, congenital malformations, newborn screening
MeSH terms
Blood Specimen Collection, Homocysteine, Humans, Mass Screening, Reference Values, Risk Assessment, Evidence-Based Medicine, Clinical Laboratory Techniques

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