Homocysteine - from disease biomarker to disease prevention - PubMed (original) (raw)

Review

. 2021 Oct;290(4):826-854.

doi: 10.1111/joim.13279. Epub 2021 Apr 6.

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• PMID: 33660358
• DOI: 10.1111/joim.13279

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Review

Homocysteine - from disease biomarker to disease prevention

A D Smith et al. J Intern Med. 2021 Oct.

Free article

Abstract

We have reviewed the literature and have identified more than 100 diseases or conditions that are associated with raised concentrations of plasma total homocysteine. The commonest associations are with cardiovascular diseases and diseases of the central nervous system, but a large number of developmental and age-related conditions are also associated. Few other disease biomarkers have so many associations. The clinical importance of these associations becomes especially relevant if lowering plasma total homocysteine by B vitamin treatment can prevent disease and so improve health. Five diseases can at least in part be prevented by lowering total homocysteine: neural tube defects, impaired childhood cognition, macular degeneration, primary stroke, and cognitive impairment in the elderly. We conclude from our review that total homocysteine values in adults of 10 μmol/L or below are probably safe, but that values of 11 μmol/L or above may justify intervention. Homocysteine is more than a disease biomarker: it is a guide for the prevention of disease.

Keywords: B vitamins; cardiovascular disease; cognitive impairment; dementia; stroke.

© 2021 The Association for the Publication of the Journal of Internal Medicine.

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Comment in

• Homocysteine - what is it good for?
  Miller JW. Miller JW. J Intern Med. 2021 Oct;290(4):934-936. doi: 10.1111/joim.13288. Epub 2021 Apr 19. J Intern Med. 2021. PMID: 33738835 No abstract available.
• Reclaiming the importance of homocysteine as a marker of cardiovascular and neurologic disease.
  Elias MF. Elias MF. J Intern Med. 2021 Nov;290(5):1098-1099. doi: 10.1111/joim.13305. Epub 2021 Jun 10. J Intern Med. 2021. PMID: 34110042 No abstract available.

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