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Glomerular filtration rate as measured by serum cystatin C is an important determinant of plasma homocysteine and serum methylmalonic acid in the elderly.
- Source :
-
Journal of Internal Medicine . Jan2007, Vol. 261 Issue 1, p65-73. 9p. 3 Charts, 2 Graphs. - Publication Year :
- 2007
-
Abstract
- Objectives. To explore the dependence of glomerular filtration rate (GFR) on plasma total homocysteine (tHcy) and serum methylmalonic acid (MMA), as well as the consequences for the diagnosis of cobalamin and/or folic acid deficiency in an elderly community-dwelling population. Design and setting. Population-based study of 209 community-dwelling subjects, mean age 76 years. Interventions. Four months’ treatment study with oral vitamin B12, folic acid and B6 or placebo. Main outcome measures. Determinants of tHcy and MMA: cystatin C as a marker of GFR and serum/plasma concentrations of vitamin B12 and folate, age and sex. Results. Elevated cystatin C (>1.55 mg L−1) was found in 31.3% (men) and 13.0% (women). Elevated tHcy (≥16 μmol L−1) occurred in 53% and elevated MMA (≥0.34 μmol L−1) in 11% of all subjects. When GFR was taken into consideration, the proportion of elevated tHcy was reduced to 10% (20/209), whilst the proportion of elevated MMA was unchanged. Cystatin C was correlated with tHcy ( r = 0.45, P < 0.001) and with MMA ( r =0.28, P < 0.001), independently of vitamin B12- and folate status. According to multiple regression, independent predictors for tHcy were plasma folate (15%), cystatin C (11%) and vitamin B12 (4%), and for MMA, cystatin C (8%) and vitamin B12 (2%). Conclusions. The prevalence of elevated tHcy may be overestimated in elderly populations unless GFR is taken into account. Nomograms for evaluation of tHcy and MMA in relation to both cystatin C and serum creatinine are presented. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09546820
- Volume :
- 261
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23573919
- Full Text :
- https://doi.org/10.1111/j.1365-2796.2006.01732.x