Hyperhomocysteinemia and low B vitamin levels are independently associated with venous thromboembolism:: results from the EDITH study:: a hospital-based case-control study

Background: Moderate hyperhomocysteinemia and B vitamins deficiency are thought to be risk factors for venous thromboembolism (VTE). The causality and independence of those associations are still questioned. Methods: We measured fasting serum total homocysteine, folates, and vitamin B12 levels as well as 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T genotypes in 467 patients hospitalized with a first well-documented deep vein thrombosis and/or pulmonary embolism not related to a major acquired risk factor and 467 controls matched for gender and age. Results: Mild hyperhomocysteinemia, low serum folates, and vitamin B12 were associated with VTE independently of each other. In multivariate analysis, odds ratios (OR) (95% CI) for VTE associated with mild hyperhomocysteinemia (> 15 mu mol L-1), low serum folates (<= 4.9 nmol L-1), and vitamin B12 (<= 253 pmol L-1) were 1.48 (1.05-2.08), 3.14 (1.35-7.32) and 1.42 (1.03-1.98), respectively. An MTHFRC677T genotype was not significantly associated with VTE; OR (95% CI): 1.13 (0.70-1.81) Conclusions: The current data provides further knowledge in the complex relationship between hyperhomocysteinemia, low vitamin levels, and VTE.