Distribution and correlates of elevated total homocyst(e)ine: The Stroke Prevention in Young Women Study

PURPOSE: To determine the distribution and correlates of elevated total homocyst(e)ine (tHcy) concentration in a population of premenopausal black and white women. METHODS: Data from the Stroke Prevention in Young Women Study (N = 304), a population-based study of risk factors for stroke in women aged 15-44 years of age, were used to determine the distribution and correlates of elevated tHcy in black (N = 103) and white women (N = 201). RESULTS: The mean tHcy level for the population was 6.58 mu mol/L (range 2.89-26.5 mu mol/L). Mean tHcy levels increased with age, cholesterol level, alcohol intake, and number of cigarettes smoked tall: (p < 0.05). There were no race differences (mean tHcy 6.72 mu mol/L among blacks and 6.51 mu mol/L among whites; p = 0.4346). Regular use of multivitamins and increasing education was associated with significant reductions in tHcy concentration. Approximately 13% of the sample had elevated tHcy levels, defined as a tHcy concentration greater than or equal to 10.0 mu mol/L. Multivariate-adjusted correlates of elevated tHcy included education > 12 vs. less than or equal to 12 (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2-0.8); smoking greater than or equal to 20 cigarettes/day vs. nonsmokers (OR = 2.8, 95% CI = 1.1-7.3); and the regular use of multivitamins (OR = 0.4, 95% CI = 0.2-0.9). CONCLUSIONS: These results suggest that a substantial proportion of healthy young premenopausal women have tHcy levels that increase their risk for vascular disease. A number of potentially modifiable behavioral and environmental factors appear to be significantly related to elevated tHcy levels in young women.