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Total plasma homocysteine, folate, and vitamin b12 status in healthy Iranian adults: the Tehran homocysteine survey (2003–2004)/a cross – sectional population based study

Hossein Fakhrzadeh1*, Sara Ghotbi2, Rasoul Pourebrahim2, Masoumeh Nouri3, Ramin Heshmat4, Fatemeh Bandarian2, Alireza Shafaee5 and Bagher Larijani6

Author Affiliations

1 Assistant Professor of Cardiology, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 PhD candidate of Epidemiology, Epidemiology and Biostatistics Dep., Public Health School, Tehran University of Medical Sciences, Tehran, Iran

4 PhD candidate of Health Services Management, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 MD laboratory, Researcher, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran

6 Professor of Internal Medicine and Endocrinology, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran

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BMC Public Health 2006, 6:29  doi:10.1186/1471-2458-6-29

Published: 13 February 2006

Abstract

Background

Elevated plasma total homocysteine is an independent risk factor for cardiovascular disease and a sensitive marker of the inadequate vitamin B12 and folate insufficiency. Folate and vitamin B12 have a protective effect on cardiovascular disease. This population based study was conducted to evaluate the plasma total homocysteine, folate, and vitamin B12 in healthy Iranian individuals.

Methods

This study was a part of the Cardiovascular Risk Factors Survey in the Population Lab Region of Tehran University has been designed and conducted based on the methodology of MONICA/WHO Project. A total of 1214 people aged 25–64 years, were recruited and assessed regarding demographic characteristics, homocysteine, folate, and vitamin B12 levels with interview, questionnaires, examination and blood sampling. Blood samples were gathered and analyzed according to standard methods.

Results

The variables were assessed in 1214 participants including 428 men (35.3%) and 786 women (64.7%). Age-adjusted prevalence of hyperhomocysteinemia (Hcy≥15 μmol/L) was 73.1% in men and 41.07% in women (P < 0.0001). Geometric mean of plasma homocysteine was 19.02 ± 1.46 μmol/l in men and 14.05 ± 1.45 μmol/l in women (P < 0.004) which increased by ageing. Age-adjusted prevalence of low serum folate level was 98.67% in men and 97.92% in women. Age-adjusted prevalence of low serum vitamin B12 level was 26.32% in men and 27.2% in women. Correlation coefficients (Pearson's r) between log tHcy and serum folate, and vitamin B12 indicated an inverse correlation (r = -0.27, r = -0.19, P < 0.0001, respectively).

Conclusion

These results revealed that the prevalence of hyperhomocysteinemia, low folate and vitamin B12 levels are considerably higher than other communities. Implementation of preventive interventions such as food fortification with folic acid is necessary.