Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies

被引:182
作者
Ford, ES
Smith, SJ
Stroup, DF
Steinberg, KK
Mueller, PW
Thacker, SB
机构
[1] Ctr Dis Control & Prevent, Div Nutr & Phys Activ, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA
[2] Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hlth Lab Sci, Atlanta, GA 30341 USA
[3] Ctr Dis Control & Prevent, Epidemiol Program Off, Atlanta, GA 30341 USA
关键词
homocyst(e)ine; meta-analysis; cardiovascular disease;
D O I
10.1093/ije/31.1.59
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Elevated concentrations of homocyst(e)ine are thought to increase the risk of vascular diseases including coronary heart disease and cerebrovascular disease. Methods We searched MEDLINE (1966-1999), EMBASE (1974-1999), SciSearch (1974-1999), and Dissertation Abstracts (1999) for articles and theses about homocyst(e)ine concentration and coronary heart disease and cerebrovascular disease. Results We included 57 publications (3 cohort studies, 12 nested case-control studies, 42 case-control studies) that reported results on 55 18 people with coronary heart disease (11 068 control subjects) and 1817 people with cerebrovascular disease (4787 control subjects) in our analysis. For coronary heart disease, the summary odds ratios (OR) for a 5-mumol/l increase in homocyst(e)ine concentration were 1.06 (95% CI : 0.99-1.13) for 2 publications of cohort studies, 1.23 (95% CI : 1.07-1.41) for 10 publications of nested case-control studies, and 1.70 (95% CI: 1.50-1.93) for 26 publications of case-control studies. For cerebrovascular disease, the summary OR for a 5-mumol/l increase in homocyst(e)ine concentration were 1.10 (95% CI: 0.94-1.28) for 2 publications of cohort studies, 1.58 (95% CI: 1.35-1.85) for 5 publications of nested case-control studies, and 2.16 (95% CI: 1.65-2.82) for 17 publications of case-control studies. Conclusions Prospective studies offer weaker support than case-control studies for an association between homocyst(e)ine concentration and cardiovascular disease. Although other lines of evidence support a role for homocyst(e)ine in the pathogenesis of cardiovascular disease, more information from prospective epidemiological studies or clinical trials is needed to clarify this role.
引用
收藏
页码:59 / 70
页数:12
相关论文
共 122 条
[1]   RELATION OF SERUM HOMOCYSTEINE AND LIPOPROTEIN(A) CONCENTRATIONS TO ATHEROSCLEROTIC DISEASE IN A PROSPECTIVE FINNISH POPULATION-BASED STUDY [J].
ALFTHAN, G ;
PEKKANEN, J ;
JAUHIAINEN, M ;
PITKANIEMI, J ;
KARVONEN, M ;
TUOMILEHTO, J ;
SALONEN, JT ;
EHNHOLM, C .
ATHEROSCLEROSIS, 1994, 106 (01) :9-19
[2]   INFLUENCE OF HYDROLYSIS ON PLASMA HOMOCYSTEINE DETERMINATION IN HEALTHY-SUBJECTS AND PATIENTS WITH MYOCARDIAL-INFARCTION [J].
ANDERSSON, A ;
ISAKSSON, A ;
BRATTSTROM, L ;
ISRAELSSON, B ;
HULTBERG, B .
ATHEROSCLEROSIS, 1991, 88 (2-3) :143-151
[3]  
[Anonymous], SUMMING UP SCI REVIE
[4]   PLASMA SULFHYDRYL-CONTAINING AMINO-ACIDS IN PATIENTS WITH CEREBRAL INFARCTION AND IN HYPERTENSIVE SUBJECTS [J].
ARAKI, A ;
SAKO, Y ;
FUKUSHIMA, Y ;
MATSUMOTO, M ;
ASADA, T ;
KITA, T .
ATHEROSCLEROSIS, 1989, 79 (2-3) :139-146
[5]   SERUM TOTAL HOMOCYSTEINE AND CORONARY HEART-DISEASE [J].
ARNESEN, E ;
REFSUM, H ;
BONAA, KH ;
UELAND, PM ;
FORDE, OH ;
NORDREHAUG, JE .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1995, 24 (04) :704-709
[6]   Association between plasma homocysteine and coronary artery disease in older persons [J].
Aronow, WS ;
Ahn, C .
AMERICAN JOURNAL OF CARDIOLOGY, 1997, 80 (09) :1216-&
[7]   Association between plasma homocysteine and extracranial carotid arterial disease in older persons [J].
Aronow, WS ;
Ahn, C ;
Schoenfeld, MR .
AMERICAN JOURNAL OF CARDIOLOGY, 1997, 79 (10) :1432-&
[8]  
Blacher J, 1996, ARCH MAL COEUR VAISS, V89, P1241
[9]   HETEROZYGOSITY FOR HOMOCYSTINURIA IN PREMATURE PERIPHERAL AND CEREBRAL OCCLUSIVE ARTERIAL-DISEASE [J].
BOERS, GHJ ;
SMALS, AGH ;
TRIJBELS, FJM ;
FOWLER, B ;
BAKKEREN, JAJM ;
SCHOONDERWALDT, HC ;
KLEIJER, WJ ;
KLOPPENBORG, PWC .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 313 (12) :709-715
[10]   Nonfasting plasma total homocysteine levels and stroke incidence in elderly persons: The Framingham Study [J].
Bostom, AG ;
Rosenberg, IH ;
Silbershatz, H ;
Jacques, PF ;
Selhub, J ;
D'Agostino, RB ;
Wilson, PWF ;
Wolf, PA .
ANNALS OF INTERNAL MEDICINE, 1999, 131 (05) :352-355