Dietary protein and plasma total homocysteine, cysteine concentrations in coronary angiographic subjects

Abstract

Background: Dietary patterns are associated with plasma total homocysteine (tHcy) concentrations in healthy populations, but the associations between dietary protein and tHcy, total cysteine (tCys) in high risk populations are unclear. We therefore examined the association between dietary protein and tHcy and tCys concentrations in coronary angiographic subjects.

Methods: We conducted a cross-sectional study of 1015 Chinese patients who underwent coronary angiography (40-85 y old). With the use of food-frequency questionnaires, we divided the total protein intakes into high animal-protein and high plant-protein diets. Circulating concentrations of tHcy and tCys were simultaneously measured by high-performance liquid chromatography with fluorescence detection.

Results: We found that high animal-protein diet was positively associated with hyperhomocysteinemia after adjustment for potential confounders, with the subjects in the highest quartile of intake having the greatest increase in risk (OR: 4.14, 95% CI: 2.67-6.43), whereas high plant-protein diet was inversely related to hyperhomocysteinemia, with a higher intake being protective. Compared with the first quartile of intake, the adjusted OR was 0.59 (95% CI: 0.38-0.91) for the fourth quartile. The total protein intake was positively associated with the risk of hypercysteinemia and the participants in highest quartile had significant OR of 1.69 (95% CI: 1.02-2.87) compared with those in lowest quartile. In multivariate linear regression analyses, high animal-protein and total-protein intakes were positively associated with plasma tHcy and tCys concentrations. The plant-protein intake was a negative determinant of plasma tHcy concentrations.

Conclusions: High animal-protein diet was positively associated with high tHcy concentrations, whereas high plant-protein diet was inversely associated with tHcy concentrations. Furthermore the total protein intake was strongly related to tCys concentrations.

Figure 1

Dose–response relationship between dietary protein and plasma tHcy, tCys concentrations. Estimated mean (and 95% CI) plasma tHcy (A) and tCys (B) concentrations according to the intake of different types of protein after adjustment for age, sex, body mass index, waist hip ratio and total energy intake by additive Gaussian generalized regression model. n = 965. Middle lines, the estimated dose–response curves; up and below lines, 95% CIs. P values are from corresponding multiple linear regression analyses. The lowest and highest 2.5 percentiles of protein intakes are not included.