Associations Between Medication Use and Homocysteine Levels in an Older Population, and Potential Mediation by Vitamin B12 and Folate: Data from the B-PROOF Study

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• 作者：Annelies C. Ham (1)
  Anke W. Enneman (1)
  Suzanne C. van Dijk (1)
  Sadaf Oliai Araghi (1)
  Karin M. A. Swart (2)
  Evelien Sohl (2)
  Janneke P. van Wijngaarden (3)
  Nikita L. van der Zwaluw (3)
  Elske M. Brouwer-Brolsma (3)
  Rosalie A. M. Dhonukshe-Rutten (3)
  Natasja M. van Schoor (2)
  Tischa J. M. van der Cammen (1)
  M. Carola Zillikens (1)
  Robert de Jonge (4)
  Paul Lips (2) (5)
  Lisette C. P. G. M. de Groot (3)
  Joyce B. J. van Meurs (1)
  André G. Uitterlinden (1) (4) (6)
  Renger F. Witkamp (3)
  Bruno H. C. Stricker (1) (6)
  Nathalie van der Velde (1) (7)
  
• 刊名：Drugs & Aging
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：31
• 期：8
• 页码：611-621
• 全文大小：351 KB
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• 作者单位：Annelies C. Ham (1)
  Anke W. Enneman (1)
  Suzanne C. van Dijk (1)
  Sadaf Oliai Araghi (1)
  Karin M. A. Swart (2)
  Evelien Sohl (2)
  Janneke P. van Wijngaarden (3)
  Nikita L. van der Zwaluw (3)
  Elske M. Brouwer-Brolsma (3)
  Rosalie A. M. Dhonukshe-Rutten (3)
  Natasja M. van Schoor (2)
  Tischa J. M. van der Cammen (1)
  M. Carola Zillikens (1)
  Robert de Jonge (4)
  Paul Lips (2) (5)
  Lisette C. P. G. M. de Groot (3)
  Joyce B. J. van Meurs (1)
  André G. Uitterlinden (1) (4) (6)
  Renger F. Witkamp (3)
  Bruno H. C. Stricker (1) (6)
  Nathalie van der Velde (1) (7)
  
  1. Department of Internal Medicine, Erasmus MC, Geriatric Section, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
  2. Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
  3. Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
  4. Department of Clinical Chemistry, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
  5. Department of Endocrinology, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
  6. Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
  7. Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, P.O. Box 22700, 1100 DD, Amsterdam, The Netherlands
  
• ISSN：1179-1969

文摘

Background Elevated homocysteine levels are a risk indicator for cardiovascular disease, fractures and cognitive decline. Previous studies indicated associations between homocysteine levels and medication use, including antihypertensive, lipid-lowering and antidiabetic medication. However, results were often contradictory and inconclusive. Our objective was to study the associations established previously in more detail by sub-classifying medication groups, and investigate the potential mediating role of vitamin B12 and folate status. Materials and Methods Baseline data from the B-PROOF (B-vitamins for the PRevention Of Osteoporotic Fractures) study were used. We included 2,912 participants aged ?5?years, with homocysteine levels of 12-0?μmol/L and creatinine levels ?50?μmol/L, for whom self-reported medication data were available. We used multivariable linear regression models and analysis of covariance to assess the association between medication use and plasma homocysteine levels, and the potential mediation by serum vitamin B12 and folate. Results The mean age was 74?years (standard deviation, 6.5), 50?% were women, and median homocysteine levels were 14?μmol/L [interquartile range, 13-7 μmol/L]. Higher mean homocysteine levels were observed in users vs. non-users for diuretics (15.2 vs. 14.9, p?=?0.043), high-ceiling sulphonamide diuretics (16.0 vs. 14.9, p?p?=?0.029) and metformin (15.6 vs. 15.1, p?=?0.006). Non-selective β-blocker use was associated with lower mean homocysteine levels (14.4 vs. 15.0, p?=?0.019). Only this association was mediated by an underlying association with vitamin B12 and folate levels. Conclusion The associations between homocysteine levels and medication use appear to be fairly modest. Our results suggest that medication use is unlikely to contribute to clinically relevant changes in plasma homocysteine levels.