Distribution and Correlates of Elevated Total Homocyst(e)ine: The Stroke Prevention In Young Women Study

Giles, Wayne H; Kittner, Steven J; Croft, Janet B; Wozniak, Marcella A; Wityk, Robert J; Stern, Barney J; Sloan, Michael A; Price, Thomas R; McCarter, Robert J; Macko, Richard F; Johnson, Constance J; Feeser, Barbara R; Earley, Christopher J; Buchholz, David W; Stolley, Paul D

« Previous Next »Annals of Epidemiology
Volume 9, Issue 5 , Pages 307-313, July 1999

Distribution and Correlates of Elevated Total Homocyst(e)ine:

The Stroke Prevention In Young Women Study

Wayne H Giles, MD, MS
- Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
- Address reprint requests to: Wayne H. Giles, MD, MS, Cardiovascular Health Branch, CDC, 4770 Buford Hwy MS K-47, Atlanta, GA
Steven J Kittner, MD, MPH
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
- Geriatrics Research, Education and Clinical Center, University of Maryland School of Medicine, Baltimore, MD USA
- Department Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD USA
Janet B Croft, PhD
- Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
Marcella A Wozniak, MD, PhD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
Robert J Wityk, MD
- Department of Neurology, Johns Hopkins University, Baltimore, MD USA
Barney J Stern, MD
- Department of Neurology, Emory University, Atlanta, GA USA
Michael A Sloan, MD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
- Department Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD USA
Thomas R Price, MD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
- Department Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD USA
Robert J McCarter, ScD
- Department Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD USA
Richard F Macko, MD
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
- Geriatrics Research, Education and Clinical Center, University of Maryland School of Medicine, Baltimore, MD USA
Constance J Johnson, MD
- Department of Neurology, Johns Hopkins University, Baltimore, MD USA
Barbara R Feeser, MPH
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
Christopher J Earley, MD, PhD
- Department of Neurology, Johns Hopkins University, Baltimore, MD USA
David W Buchholz, MD
- Department of Neurology, Johns Hopkins University, Baltimore, MD USA
Paul D Stolley, MD, MPH
- Department Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD USA

Received 22 June 1998; received in revised form 4 February 1999; accepted 5 February 1999.

Abstract

PURPOSE: To determine the distribution and correlates of elevated total homocyst(e)ine (tHcy) concentration in a population of premenopausal black and white women.

METHODS: Data from the Stroke Prevention in Young Women Study (N = 304), a population-based study of risk factors for stroke in women aged 15–44 years of age, were used to determine the distribution and correlates of elevated tHcy in black (N = 103) and white women (N = 201).

RESULTS: The mean tHcy level for the population was 6.58 μmol/L (range 2.89–26.5 μmol/L). Mean tHcy levels increased with age, cholesterol level, alcohol intake, and number of cigarettes smoked (all: p < 0.05). There were no race differences (mean tHcy 6.72 μmol/L among blacks and 6.51 μmol/L among whites; p = 0.4346). Regular use of multivitamins and increasing education was associated with significant reductions in tHcy concentration. Approximately 13% of the sample had elevated tHcy levels, defined as a tHcy concentration ⩾ 10.0 μmol/L. Multivariate-adjusted correlates of elevated tHcy included education > 12 vs. ⩽ 12 (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2–0.8); smoking ⩾ 20 cigarettes/day vs. nonsmokers (OR = 2.8, 95% CI = 1.1–7.3); and the regular use of multivitamins (OR = 0.4, 95% CI = 0.2–0.9).

CONCLUSIONS: These results suggest that a substantial proportion of healthy young premenopausal women have tHcy levels that increase their risk for vascular disease. A number of potentially modifiable behavioral and environmental factors appear to be significantly related to elevated tHcy levels in young women.

Keywords: Homocysteine, Women, Race, Correlates

Abbreviations: tHcy = total homocyst(e)ine, OR = odds ratio, CI = confidence interval