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(Circulation. 1999;99:2144-2149.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

Plasma Homocysteine Distribution and Its Association With Parental History of Coronary Artery Disease in Black and White Children

The Bogalusa Heart Study

Kurt J. Greenlund, PhD; Sathanur R. Srinivasan, PhD; Ji-Hua Xu, MD; Edward Dalferes, Jr, BS; Leann Myers, PhD; Arthur Pickoff, MD; Gerald S. Berenson, MD

From the Tulane Center for Cardiovascular Health (K.J.G., S.R.S., J.-H.X., E.D., G.S.B.) and the Department of Biostatistics and Epidemiology (L.M.), Tulane University School of Public Health and Tropical Medicine; and Department of Pediatrics (A.P.), Tulane University Medical School, New Orleans, La.

Correspondence to Gerald S. Berenson, MD, Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, 1501 Canal St, 14th Floor, New Orleans, LA 70112.

Background—Elevated homocysteine is associated with increased risk for coronary artery disease (CAD) in adults, but its distribution in children is not well documented. We examined the distribution of homocysteine in children and its relation to parental history of CAD.

Methods and Results—A subsample of 1137 children (53% white, 47% black) aged 5 to 17 years in 1992 to 1994 examined in the Bogalusa Heart Study (n=3135), including all with a positive parental history of CAD (n=154), had plasma homocysteine levels measured. Homocysteine correlated positively with age (r=0.16, P=0.001). No race or sex differences in homocysteine levels were observed; geometric mean (GM) levels were 5.8 µmol/L (95% CI, 5.6 to 6.1) among white males, 5.8 µmol/L (95% CI, 5.5 to 6.0) among white females, 5.6 µmol/L (95% CI, 5.4 to 5.8) among black males, and 5.6 µmol/L (95% CI, 5.4 to 5.9) among black females. Children with a positive parental history of CAD had a significantly greater age-adjusted GM homocysteine level (GM, 6.7 µmol/L; 95% CI, 6.4 to 7.1) than those without a positive history (GM, 5.6 µmol/L; 95% CI, 5.4 to 5.7); this relation was observed in each race-sex group.

Conclusions—Higher homocysteine levels were observed among children with a positive family history of CAD. Additional studies should elucidate the contribution of genetic, dietary, and other factors to homocysteine levels in children.

Key Words: homocysteine • coronary disease • pediatrics • risk factors

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