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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Vitamin B12 deficiency is associated with coronary artery disease in an Indian population

Jitender Kumar1 / Gaurav Garg2 / Elayanambi Sundaramoorthy3 / P. Veerendra Prasad4 / Ganesan Karthikeyan5 / Lakshmy Ramakrishnan6 / Saurabh Ghosh7 / Shantanu Sengupta8

1Proteomics and Structural Biology Unit, Institute of Genomics and Integrative Biology, Delhi, India

2Proteomics and Structural Biology Unit, Institute of Genomics and Integrative Biology, Delhi, India

3Proteomics and Structural Biology Unit, Institute of Genomics and Integrative Biology, Delhi, India

4Human Genetics Unit, Indian Statistical Institute, B.T. Road, Kolkata, India

5Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

6Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

7Human Genetics Unit, Indian Statistical Institute, B.T. Road, Kolkata, India

8Proteomics and Structural Biology Unit, Institute of Genomics and Integrative Biology, Delhi, India

Corresponding author: Shantanu Sengupta, Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007 Phone: +91-11-27666156, Fax: +91-11-27667471,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 47, Issue 3, Pages 334–338, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2009.074, February 2009

Publication History

Received:
2008-10-30
Accepted:
2008-12-18
Published Online:
2009-02-04

Abstract

Background: The incidence of coronary artery disease (CAD) is increasing at an alarming rate, especially in developing countries, such as India. It is often advocated that a vegetarian lifestyle could reduce the burden of CAD. However, in spite of a majority of Indians being vegetarians, the incidence of CAD is highest in this population. This may be due to deficiency of vitamin B12, a micronutrient, sourced only from animal products.

Methods: Herein, we assessed the effect of vitamin B12 with respect to CAD in 816 individuals (368 CAD patients and 448 controls) recruited from a tertiary care center in New Delhi, India.

Results: We found that vitamin B12 levels were significantly lower in CAD patients than in controls (p<0.0001). Also, vegetarians were found to have significantly lower vitamin B12 concentrations (p=0.0001) and higher incidence of CAD (p=0.01). Interestingly, elevated homocysteine levels, a hallmark of vitamin B12 deficiency, was not associated with CAD. In contrast, cysteine levels were significantly higher in CAD patients than in controls (p=0.004).

Conclusions: We believe that, when vitamin B12 is deficient, homocysteine is rapidly metabolized via the transsulfuration pathway leading to increased cysteine levels.

Clin Chem Lab Med 2009;47:334–8.

Keywords: coronary artery disease; cysteine; homocysteine; vegetarian diet; vitamin B12

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