American Journal of Epidemiology Vol. 152, No. 2 : 140-148
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Total Homocysteine and Estrogen Status Indicators in the Third National Health and Nutrition Examination Survey
From the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA.
The possibility that estrogen status modulates total homocysteine concentration, a risk factor for vascular occlusion, was examined in a representative sample of the US population, the Third National Health and Nutrition Examination Survey (phase 2), 1991–1994. The geometric mean serum total homocysteine concentration was compared among population subgroups differing on inferred estrogen status, after adjusting for potential confounding by age, race-ethnicity, smoking, and the serum concentration of creatinine, folate, and vitamin B-12. Premenopausal women aged 17–54 years had a lower mean serum total homocysteine concentration (8.1 µmol/liter, 95% confidence interval (CI): 7.9, 8.2) than men in the same age range (8.9 µmol/liter, 95% CI: 8.6, 9.3). In the age range 17–44 years, pregnant women (6.0 µmol/liter, 95% CI: 5.4, 6.8), but not oral contraceptive users (7.9 µmol/liter, 95% CI: 7.6, 8.2), had a lower mean serum total homocysteine concentration than nonpregnant, non-oral-contraceptive-using women (8.1 µmol/liter, 95% CI: 7.9, 8.2). The mean serum total homocysteine concentration of estrogen-using women aged 
55 years (9.5 µmol/liter, 95% CI: 8.9, 10.1) was significantly decreased relative to nonestrogen users (10.7 µmol/liter, 95% CI: 10.3, 11.1) and men (10.4 µmol/liter, 95% CI: 9.8, 11.0) in the same age range. These findings suggest that higher estrogen status is associated with a decreased mean serum total homocysteine concentration, independent of nutritional status and muscle mass, and that estrogen may explain the previously reported male-female difference in total homocysteine concentration.
cardiovascular diseases; estrogen replacement therapy; homocysteine; menopause; premenopause
Abbreviations: FSH, follicle-stimulating hormone; NHANES III, Third National Health and Nutrition Examination Survey.
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