(Circulation. 2001;103:2544.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Plasma Total Cysteine as a Risk Factor for Vascular Disease
The European Concerted Action Project
From LOCUS for Homocysteine and Related Vitamins (L.E., P.M.U., H.R, S.E.V.), University of Bergen, Bergen, Norway; and the Department of Cardiology (I.M.G.), Adelaide-Meath Hospital, Incorporating the National Children’s Hospital, Tallaght, Dublin, Ireland.
Correspondence to Lina El-Khairy, Section for Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Armauer Hansens Hus, N-5021 Bergen, Norway. E-mail lina.el-khairy{at}smis.uib.no
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.
Key Words: cardiovascular diseases • amino acids • risk factors
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