British Journal of Nutrition

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British Journal of Nutrition (2010), 104:893-899 Cambridge University Press
Copyright © The Authors 2010
doi:10.1017/S0007114510001236

Full Papers

Dietary Surveys and Nutritional Epidemiology

Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over


Christopher J. Batesa1 c1, Mohammed A. Mansoora2, Kristina D. Pentievaa3, Mark Hamera4 and Gita D. Mishraa4

a1 MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
a2 Department of Natural Sciences, University of Agder, Kristiansand, Norway
a3 Northern Ireland Centre for Food and Health, School of Biomedical Sciences, University of Ulster, Coleraine BT52 1SA, UK
a4 Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
Article author query
bates cj [PubMed]  [Google Scholar]
mansoor ma [PubMed]  [Google Scholar]
pentieva kd [PubMed]  [Google Scholar]
hamer m [PubMed]  [Google Scholar]
mishra gd [PubMed]  [Google Scholar]

Abstract

Predictive power, for total and vascular mortality, of selected indices measured at baseline in the British National Diet and Nutrition Survey (community-living subset) of People Aged 65 Years and Over was tested. Mortality status and its primary and underlying causes were recorded for 1100 (mean age 76·7 (sd 7·5) years, 50·2 % females) respondents from the baseline survey in 1994–5 until September 2008. Follow-up data analyses focussed especially on known predictors of vascular disease risk, together with intakes and status indices of selected nutrients known to affect, or to be affected by, these predictors. Total mortality was significantly predicted by hazard ratios of baseline plasma concentrations (per sd) of total homocysteine (tHcy) (95 % CI) 1·19 (1·11, 1·27), pyridoxal phosphate 0·90 (0·81, 1·00), pyridoxic acid 1·10 (1·03, 1·19), α1-antichymotrypsin 1·21 (1·13, 1·29), fibrinogen 1·14 (1·05, 1·23), creatinine 1·20 (1·10, 1·31) and glycosylated Hb 1·23 (1·14, 1·32), and by dietary intakes of energy 0·87 (0·80, 0·96) and protein 0·86 (0·77, 0·97). Prediction patterns and significance were similar for primary-cause vascular mortality. The traditional risk predictors plasma total and HDL cholesterol were not significant mortality predictors in this age group, nor were the known tHcy-regulating nutrients, folate and vitamin B12 (intakes and status indices). Model adjustment for known risk predictors resulted in the loss of significance for some of the afore-mentioned indices; however, tHcy 1·34 (1·04, 1·73) remained a significant predictor for vascular mortality. Thus, total and primary vascular mortality is predicted by energy and protein intakes, and by biochemical indices including tHcy, independent of serum folate or vitamin B12.

(Received November 19 2009)

(Revised March 08 2010)

(Accepted March 09 2010)

(Online publication April 19 2010)

Key Words:British National Survey of older adults; Mortality prediction; Intakes and biochemical indices; Plasma homocysteine; B-vitamins and inflammatory indices

Correspondence:

c1 Corresponding author: Dr Christopher J. Bates, email chris.bates@mrc-hnr.cam.ac.uk

Footnotes

Abbreviations: HbA1c, glycosylated Hb; ICD, International Classification of Diseases; tHcy, total homocysteine