doi: 10.1161/CIRCULATIONAHA.106.644674
(Circulation. 2006;114:e548.)
© 2006 American Heart Association, Inc.
Correspondence |
Response to Letter Regarding Article, "Relationship Between Homocysteine and Mortality in Chronic Kidney Disease"
Department of Medicine, Division of Nephrology, Tufts-New England Medical Center, Boston, Mass
Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio
National Institutes of Health, Bethesda, Md
Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, Mass
Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minn
General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco, Calif
In commenting on our article,1 Undas and Jakubowski suggest that levels of total homocysteine (tHcy) may not adequately capture excess cardiovascular risk due to sub-species or metabolites of homocysteine. However, several previous studies that have demonstrated a relation between hyperhomocysteinemia and increased risk of mortality have measured tHcy.2–6 Moreover, the Hcy-protein adducts that are implicated by Undas and Jakubowski as potential mediators of tHcy toxicity also accumulate in kidney disease.7 Thus, like tHcy, levels of subspecies of Hcy and its metabolites may also be related to level of kidney function. Therefore, any examination of the relation between Hcy and cardiovascular disease must include adjustment for level of kidney function.
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Acknowledgments |
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Disclosures
None.
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References |
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