Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.

BACKGROUND: In epidemiological studies, within-person variability in plasma total homocysteine (tHcy) measurements may dilute the association of 'usual' levels of tHcy with risk of cardiovascular disease, referred to as 'regression dilution'. The aim of this report was to estimat...

Full description

Bibliographic Details
Main Authors: Clarke, R, Lewington, S, Donald, A, Johnston, C, Refsum, H, Stratton, I, Jacques, P, Breteler, M, Holman, R
Format: Journal article
Language:English
Published: 2001
_version_ 1797101251417079808
author Clarke, R
Lewington, S
Donald, A
Johnston, C
Refsum, H
Stratton, I
Jacques, P
Breteler, M
Holman, R
author_facet Clarke, R
Lewington, S
Donald, A
Johnston, C
Refsum, H
Stratton, I
Jacques, P
Breteler, M
Holman, R
author_sort Clarke, R
collection OXFORD
description BACKGROUND: In epidemiological studies, within-person variability in plasma total homocysteine (tHcy) measurements may dilute the association of 'usual' levels of tHcy with risk of cardiovascular disease, referred to as 'regression dilution'. The aim of this report was to estimate the magnitude of regression dilution after varying intervals of follow-up. METHODS: Regression dilution ratios (RDR) for tHcy were calculated using replicate tHcy measurements obtained after 3, 6 and 8 years from the Rotterdam, Hordaland and Framingham studies, respectively, and after 3, 6, 9 and 12 years from the United Kingdom Prospective Study of type 2 Diabetes Mellitus (UKPDS). RESULTS: The RDR for tHcy decreased with increasing interval in the three population-based studies and in the UKPDS. Moreover, the rate of decline of the RDR in the population-based studies was similar to that obtained in the UKPDS. Using linear regression analysis for the population-based studies, these results suggest an RDR of 0.83 at 2 years, 0.71 at 6 years and 0.53 at 12 years. CONCLUSIONS: These results have important implications for the interpretation of prospective studies of tHcy and cardiovascular disease. Failure to correct for increasing regression dilution using lower RDRs for longer follow-up may underestimate the relative risks of cardiovascular disease associated with tHcy by about one-fifth after 2 years and one-half after 10 years.
first_indexed 2024-03-07T05:49:10Z
format Journal article
id oxford-uuid:e841ecf2-6800-400c-9e56-f5f19301fd8e
institution University of Oxford
language English
last_indexed 2024-03-07T05:49:10Z
publishDate 2001
record_format dspace
spelling oxford-uuid:e841ecf2-6800-400c-9e56-f5f19301fd8e2022-03-27T10:45:22ZUnderestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e841ecf2-6800-400c-9e56-f5f19301fd8eEnglishSymplectic Elements at Oxford2001Clarke, RLewington, SDonald, AJohnston, CRefsum, HStratton, IJacques, PBreteler, MHolman, RBACKGROUND: In epidemiological studies, within-person variability in plasma total homocysteine (tHcy) measurements may dilute the association of 'usual' levels of tHcy with risk of cardiovascular disease, referred to as 'regression dilution'. The aim of this report was to estimate the magnitude of regression dilution after varying intervals of follow-up. METHODS: Regression dilution ratios (RDR) for tHcy were calculated using replicate tHcy measurements obtained after 3, 6 and 8 years from the Rotterdam, Hordaland and Framingham studies, respectively, and after 3, 6, 9 and 12 years from the United Kingdom Prospective Study of type 2 Diabetes Mellitus (UKPDS). RESULTS: The RDR for tHcy decreased with increasing interval in the three population-based studies and in the UKPDS. Moreover, the rate of decline of the RDR in the population-based studies was similar to that obtained in the UKPDS. Using linear regression analysis for the population-based studies, these results suggest an RDR of 0.83 at 2 years, 0.71 at 6 years and 0.53 at 12 years. CONCLUSIONS: These results have important implications for the interpretation of prospective studies of tHcy and cardiovascular disease. Failure to correct for increasing regression dilution using lower RDRs for longer follow-up may underestimate the relative risks of cardiovascular disease associated with tHcy by about one-fifth after 2 years and one-half after 10 years.
spellingShingle Clarke, R
Lewington, S
Donald, A
Johnston, C
Refsum, H
Stratton, I
Jacques, P
Breteler, M
Holman, R
Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title_full Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title_fullStr Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title_full_unstemmed Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title_short Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies.
title_sort underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies
work_keys_str_mv AT clarker underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT lewingtons underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT donalda underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT johnstonc underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT refsumh underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT strattoni underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT jacquesp underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT bretelerm underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies
AT holmanr underestimationoftheimportanceofhomocysteineasariskfactorforcardiovasculardiseaseinepidemiologicalstudies