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on April 10, 2003

Arteriosclerosis, Thrombosis, and Vascular Biology. 2003
Published online before print April 10, 2003, doi: 10.1161/01.ATV.0000071348.70527.F4
A more recent version of this article appeared on June 1, 2003
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Submitted on February 25, 2003
Accepted on March 31, 2003

Genetic Evidence That Nitric Oxide Modulates Homocysteine. The NOS3 894TT Genotype Is a Risk Factor for Hyperhomocystinemia

Karen S. Brown ; Leo A.J. Kluijtmans ; Ian S. Young ; Jayne Woodside ; John W.G. Yarnell ; Dorothy McMaster ; Liam Murray ; Alun E. Evans ; Colin A. Boreham ; Helene McNulty ; J. J. Strain ; Laura E. Mitchell ; and Alexander S. Whitehead *

From the Department of Pharmacology and Center for Pharmacogenetics (K.S.B., A.S.W.), University of Pennsylvania School of Medicine, Philadelphia, Pa; Laboratory of Pediatrics and Neurology (L.A.J.K.), University Medical Center Nijmegen, The Netherlands; Cardiovascular Research Centre (I.S.Y., J.W., J.W.G.Y., D.M., L.M.) and Department of Epidemiology and Public Health (A.E.), Queen's University Belfast, Northern Ireland; Northern Ireland Centre for Diet and Health (C.A.B., H.M., J.J.S.), University of Ulster, Coleraine, Northern Ireland; and Texas A&M University System Health Science Center (L.E.M.), Institute of Biosciences and Technology, Houston, Tex.

* To whom correspondence should be addressed. E-mail: aswhitehead{at}pharm.med.upenn.edu.

Objective--Mild hyperhomocystinemia is an independent, graded risk factor for cardiovascular disease. Genetic determinants of hyperhomocystinemia include functional polymorphisms in several folate/homocysteine metabolic enzymes. Nitric oxide may also modulate plasma homocysteine (tHcy) concentrations, either by direct inhibition of methionine synthase or via an indirect effect on folate catabolism.

Methods and Results--The hypothesis that the endothelial nitric oxide synthase (NOS3) G894T polymorphism is a genetic determinant of tHcy concentrations was tested in 2 independent healthy adult populations. In both populations, NOS3 genotype was significantly associated with tHcy concentrations in nonsmokers with low folate (P=0.03 for each). Models were constructed to adjust for known determinants of tHcy concentrations and test for interactions between NOS3 genotype and these determinants in nonsmokers from each population. NOS3 genotype remained a significant determinant of tHcy concentrations after adjustment. Interactions between NOS3 genotype and serum folate were significant in both populations, and the interaction between NOS3 genotype and MTHFR C677T genotype was significant in the larger population.

Conclusions--These data indicate that NOS3 894TT genotype is a risk factor for elevated tHcy in healthy nonsmoking adults with low serum folate and supports the hypothesis that nitric oxide modulates homocysteine through an effect on folate catabolism.


Key words: nitric oxide • nitric oxide synthase • hyperhomocysteinemia • 5,10-methylenetetrahydrofolate reductase • smoking




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