Bertoia, MonicaPai, JenniferCooke, JohnJoosten, MichelMittleman, MurrayRimm, Eric Bruce::0ab2926c8242f35e5a982e3cf59f4987::600Mukamal, Kenneth2019-08-262014Bertoia, Monica L., Jennifer K. Pai, John P. Cooke, Michel M. Joosten, Murray A. Mittleman, Eric B. Rimm, and Kenneth J. Mukamal. 2014. “Plasma Homocysteine, Dietary B Vitamins, Betaine, and Choline and Risk of Peripheral Artery Disease.” Atherosclerosis 235 (1): 94–101. https://doi.org/10.1016/j.atherosclerosis.2014.04.010.0021-91501879-1484http://nrs.harvard.edu/urn-3:HUL.InstRepos:41246947Objective: Few studies have examined the roles of homocysteine and related nutrients in the development of peripheral artery disease (PAD). We examined the associations between plasma homocysteine, dietary B vitamins, betaine, choline, and supplemental folic acid use and incidence of PAD.Methods: We used two cohort studies of 72,348 women in the Nurses' Health Study (NHS, 1990-2010) and 44,504 men in the Health Professionals Follow-up Study (HPFS, 1986-2010). We measured plasma homocysteine in nested matched case-control studies of clinically recognized PAD within both cohorts, including 143 PAD cases and 424 controls within the NHS (1990-2010) and 143 PAD cases and 428 controls within the HPFS (1994-2008). We examined the association between diet and risk of incident PAD in the cohorts using a food frequency questionnaire and 790 cases of PAD over 3.1 million person-years of follow-up.Results: Higher homocysteine levels were positively associated with risk of PAD in men (adjusted IRR 2.17; 95% CI, 1.08-4.38 for tertile 3 vs. 1). There was no evidence of an association in women (adjusted IRR 1.14; 95% CI, 0.61-2.12). Similarly, higher folate intake, including supplements, was inversely associated with risk of PAD in men (adjusted HR 0.90; 95% CI, 0.82-0.98 for each 250 mu g increase) but not women (HR 1.01, 95% CI, 0.88-1.15). Intakes of the other B vitamins, betaine, and choline were not consistently associated with risk of PAD in men or women.Conclusion: Homocysteine levels were positively associated and dietary folate intake was inversely associated with risk of PAD in men but not in women. (C) 2014 Published by Elsevier Ireland Ltd.en-USJournal Article2019-08-2610.1016/j.atherosclerosis.2014.04.010