Hyperhomocysteinemia in Asian Indians Living in the United States (original) (raw)

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1Center for Human Nutrition (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

2the Department of Internal Medicine (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

3Division of Endocrinology and Metabolism (M.C., A.V.C.-C., N.A.), University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9169

*Address all correspondence and requests for reprints to: Manisha Chandalia, M.D., 6011 Harry Hines Boulevard, Dallas, Texas 75350-9169.

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1Center for Human Nutrition (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

2the Department of Internal Medicine (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

3Division of Endocrinology and Metabolism (M.C., A.V.C.-C., N.A.), University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9169

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Alberto V. Cabo-Chan, Jr.

1Center for Human Nutrition (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

2the Department of Internal Medicine (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

3Division of Endocrinology and Metabolism (M.C., A.V.C.-C., N.A.), University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9169

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4Laboratory for Atherosclerosis and Metabolic Research (S.D., I.J.); University of California Davis Medical Center, Davis, California 95616

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4Laboratory for Atherosclerosis and Metabolic Research (S.D., I.J.); University of California Davis Medical Center, Davis, California 95616

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1Center for Human Nutrition (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

2the Department of Internal Medicine (M.C., A.V.C.-C., S.M.G., N.A.), Texas 75390-9169

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Accepted:

03 December 2002

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Manisha Chandalia, Nicola Abate, Alberto V. Cabo-Chan, Sridevi Devaraj, Ishwarlal Jialal, Scott M. Grundy, Hyperhomocysteinemia in Asian Indians Living in the United States, The Journal of Clinical Endocrinology & Metabolism, Volume 88, Issue 3, 1 March 2003, Pages 1089–1095, https://doi.org/10.1210/jc.2002-021133
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Hyperhomocysteinemia has been reported in Asian Indians (people from Indian subcontinent) to be related to relatively low plasma levels of folate and vitamin B-12. However, a true ethnic-related characteristic has not been excluded. This study was done to determine whether Asian Indians have high plasma homocysteine compared with Caucasians in the United States in the era of folate fortification, and whether low vitamin B-12 or insulin resistance may account for possible interethnic differences in plasma homocysteine. A total of 227 Asian Indians (131 males and 96 females) and 155 Caucasians (66 males and 89 females) completed a questionnaire for medical, family, and personal history. They had height, weight, and blood pressure measured and fasting blood drawn for routine chemistry, TSH, plasma homocysteine, vitamin B-12, and folate. Oral glucose tolerance test and vitamin B-6 was measured in a subgroup of 66 Asian Indians (47 males and 19 females) and 63 Caucasians (33 males and 30 females). Asian Indians were found to have significantly higher plasma homocysteine than Caucasians (median of 12.6 and 8.0 μmol/liter, P < 0.0001, respectively) and lower plasma concentrations of B-6 (median 49 vs. 70 nmol/liter; P = 0.05, respectively). Plasma folate was relatively high and similar in both ethnic groups. Plasma vitamin B-12 was significantly lower in Asian Indians than Caucasians (median of 204 vs. 320 pmol/liter, P < 0.0001, respectively). Vitamin B-12 correlated significantly with plasma homocysteine. When vitamin B-12 was between 150 and 379 pmol/liter, the regression curve between vitamin B-12 and homocysteine had significantly different slope in the two ethnic groups (P value < 0.05) and Asian Indians had significantly higher homocysteine for any level of vitamin B-12. Although insulin resistance, measured as insulin area under the curve by oral glucose tolerance test was higher in Asian Indians and correlated significantly with homocysteine, it did not explain inter-ethnic differences in plasma homocysteine in a multivariate analysis. We conclude that Asian Indians living in the United States have significant elevation of plasma homocysteine concentrations despite normal plasma folate. Lower plasma concentrations of vitamin B-12 and lower insulin sensitivity may contribute to this finding but only partially explained the ethnic-related hyperhomocysteinemia of the Asian Indians.

Copyright © 2003 by The Endocrine Society

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