Homocysteine, renal disease and cardiovascular disease in a remote Australian Aboriginal community

McDonald, S. P., Maguire, G., Duarte, N., Wang, X. L. and Hoy, W. E. (2005) Homocysteine, renal disease and cardiovascular disease in a remote Australian Aboriginal community. Internal Medicine Journal, 35 5: 289-294. doi:10.1111/j.1444-0903.2005.00824.x

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Author McDonald, S. P.
Maguire, G.
Duarte, N.
Wang, X. L.
Hoy, W. E.
Title Homocysteine, renal disease and cardiovascular disease in a remote Australian Aboriginal community
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
Publication date 2005-05
Sub-type Article (original research)
DOI 10.1111/j.1444-0903.2005.00824.x
Open Access Status File (Author Post-print)
Volume 35
Issue 5
Start page 289
End page 294
Total pages 6
Editor Szer, J.
Place of publication Carlton South, Australia
Publisher Blackwell Publishing Asia
Collection year 2005
Language eng
Subject 320100 Medicine - General
730106 Cardiovascular system and diseases
321202 Epidemiology
1103 Clinical Sciences
Abstract Background: Rates of renal and cardiovascular disease are high among Aboriginal Australians living in remote communities. Nutritional problems, in particular low folate levels, are also common. This suggests that increased homocysteine concentrations might be widespread, and a possible contributor to the high rates of cardiovascular disease. Aims: To examine homocysteine concentrations, and their relationships to folate levels, and to markers of renal disease and cardiovascular disease in a remote Aboriginal Australian community. Methods: As part of a cross-sectional survey among adults in one community, homocysteine concentrations, concentrations of the crucial determinants (red blood cell (RBC) folate, vitamin B12 and the C677T methylene tetrahydrofolate reductase polymorphism) and cardiovascular risk factors were examined. Results: Among 221 people, geometric mean homocysteine concentration was 11.8 micromol/L (range: 11.1-12.5 micromol/L), with 57/221 (26%) values >/= 15.0 micromol/L. Higher concentrations were associated with older age, male gender, lower RBC folate and lower vitamin B12 concentrations and homozygosity for C677T. Homocysteine concentrations were not related to the presence of albuminuria, other than over the overt albuminuria range. Homocysteine concentrations were inversely correlated with calculated glomerular filtration rate (GFR). Carotid intima-media thickness, however, was not related to homocysteine concentration. In multivariate analyses, age, male gender, lower RBC folate concentrations, lower vitamin B12 concentrations, lower calculated GFR and the C677T polymorphism were all associated with homocysteine concentrations. Conclusions: Homocysteine concentrations were consistent with previous limited reports in Aboriginal communities. Although superficially they are similar to reports from non-Aboriginal settings, the younger age of this cohort and the association of homocysteine concentrations with age suggest that age-specific concentrations are higher among Aboriginal Australians. In addition to dietary determinants, the high prevalence of apparently reduced renal function renal disease appears to be an important determinant of homocysteine concentrations in remote Aboriginal communities. The role of homocysteine concentrations as a potential mediator of the high rates of cardiovascular disease remains to be determined.
Keyword Renal disease
Cardiovascular disease
Red blood cell folate
Australian Aborigines
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 17 Nov 2006, 10:00:00 EST by Wendy E Hoy on behalf of School of Medicine