- Clinical Investigation and Reports
Plasma Total Cysteine as a Risk Factor for Vascular Disease
The European Concerted Action Project Lina El-Khairy et al. Abstract
Background—Elevated plasma
total homocysteine (tHcy) is a risk factor for cardiovascular disease.
Although cysteine is structurally
similar and metabolically linked to tHcy, its
relation to the risk of cardiovascular disease has received little
attention.
We studied the relation between plasma total
cysteine (tCys) levels and the risk of vascular disease in the coronary,
cerebral,
and peripheral vessels.
Methods and Results—This
case-control study included 750 patients with vascular disease and 800
age- and sex-matched control subjects recruited
from 19 centers in 9 European countries.
Conventional risk factors for cardiovascular disease were recorded. In
addition,
plasma levels of tCys, tHcy, folate, B6, B12,
and creatinine were measured. Overall, a U-shaped relationship was
observed between tCys and risk of vascular disease. With
the middle range of 250 to 275 μmol/L tCys used
as the reference category, the adjusted risk of vascular disease at low
(≤225
μmol/L) tCys levels was 2.1 (95% CI 1.2 to 3.6),
and the risk at high (>300 μmol/L) tCys levels was 1.6 (95% CI 1.1
to 2.3).
Different shapes of the dose-response
relationship were seen for the 3 vascular disease categories. The
relation with peripheral
vascular and cerebrovascular disease was
U-shaped, whereas a weak positive relation was observed with coronary
heart disease.
Conclusions—Our data show a
significant U-shaped relationship between tCys and cardiovascular
disease after adjustment for tHcy, creatinine,
and other cardiovascular disease risk factors.
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