Changes in lifestyle and total homocysteine in relation to MTHFR(C677T) genotype: the Inter99 study

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Abstract

Background:

Reduction in total homocysteine (tHcy) may be clinically relevant in the prevention of cardiovascular disease (CVD) in the general population.

Objective:

To examine the effects of changes in various lifestyle habits and lifestyle related biological CVD risk markers on changes in tHcy in relation to MTHFR(C677T) genotype.

Design:

A 1 year follow-up study.

Setting:

Copenhagen County, Denmark.

Subjects:

Statistical analyses were based on a population-based sample of 915 men and women aged 30-60 years assessed to be at increased CVD risk at baseline and therefore offered lifestyle intervention and re-examination after one year.

Results:

None of the studied lifestyle changes - smoking, physical activity, dietary habits, and coffee, tea, and alcohol consumption - was significantly associated with changes in tHcy, either overall, or in any of the MTHFR genotype subgroups. In addition, changes in tHcy did not differ between participants randomized to low- and high-intensity lifestyle intervention. However, the MTHFR TT genotype was associated with a significant decrease in tHcy compared with the CC/CT genotype in which an increase was observed. In addition, changes in tHcy were associated with changes in several of the biological CVD risk markers: weight, total cholesterol, HDL cholesterol, LDL cholesterol and systolic blood pressure.

Conclusions:

Our results indicate that tHcy may not be reduced by lifestyle changes; additionally, they suggest that tHcy may be related to biological CVD risk markers through a lifestyle independent pathway.

Sponsorships:

Danish Heart Foundation, Danish Medical Research Council, Danish Centre for Evaluation and Health Technology Assessment.

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