Document Detail

Hyperhomocysteinaemia is not associated with isolated crural arterial occlusive disease: The Hoorn Study.
MedLine Citation:
PMID:  10792557     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Hyperhomocysteinaemia is an independent risk factor for peripheral arterial disease (PAD). The localization of peripheral arterial disease is clinically relevant, because proximal (aortoiliac and femoropopliteal) disease is associated with a particularly poor overall prognosis, whereas isolated distal (i.e. crural) disease is associated with a better overall prognosis. The aim of the study was to investigate whether the strength of the association between hyperhomocysteinaemia and peripheral arterial disease differs according to the localization of the anatomical obstruction. DESIGN: Fasting serum total homocysteine (tHcy) was measured in an age-, sex- and glucose-tolerance stratified random sample (n = 631) of a 50- to 75-year-old general Caucasian population. History of a peripheral arterial reconstruction was recorded. Aortoiliac, femoropopliteal and crural arterial obstructions were registered by means of Doppler flow velocity curves. RESULTS: The median serum tHcy level was 12.2 micromol L-1 (interquartile range: 10.0-15.3) in men and 10.7 micromol L-1 (interquartile range: 9.0-13.3) in women. The prevalences of aortoiliac, femoropopliteal and crural obstructions were 2.1%, 2.7% and 11.9%, respectively. After adjustment for age, sex, systolic blood pressure, current smoking, serum cholesterol and diabetes mellitus, the odds ratios (95% confidence interval) per 5 micromol L-1 tHcy increment were 1.41 (1.05-1.89) for aortoiliac, 1.03 (0. 70-1.52) for femoropopliteal and 0.82 (0.59-1.15) for crural obstructions. Finally, diabetes mellitus, HbA1c and current smoking were significantly associated with crural and femoropopliteal disease, whereas systolic blood pressure was significantly associated with aortoiliac obstructions. CONCLUSIONS: The present study indicates that hyperhomocysteinaemia is associated with aortoiliac but not with isolated crural arterial occlusive disease.
E K Hoogeveen; P J Kostense; C Jakobs; J A Rauwerda; J M Dekker; G Nijpels; L M Bouter; R J Heine; C D Stehouwer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  247     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-06     Completed Date:  2000-06-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  442-8     Citation Subset:  IM    
Institute for Research in Extramural Medicine, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
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MeSH Terms
Arterial Occlusive Diseases / blood,  diagnosis*
Blood Flow Velocity / physiology
Cross-Sectional Studies
Glucose Tolerance Test
Homocysteine / blood
Hyperhomocysteinemia / blood,  diagnosis*
Ischemia / blood,  diagnosis
Leg / blood supply
Middle Aged
Reg. No./Substance:

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