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Association between Homocysteine and sleep in postmenopausal women


Homocysteine (Hcy) is a sulfur amino acid, considered as an independent risk factor for cardiovascular disease. Excessive Hcy directly harms the endothelium and can lead to premature atherosclerosis, with progression to stroke and acute myocardial infarction. One of the causes of hyperhomocysteinemia (Hhcy) is hypoestrogenism. Low estrogen levels increase the cardiovascular risk as well as the occurrence of sleep disorders. Hhcy prevalence varies by population and its occurrence in postmenopausal women in Brazil is unknown.


To evaluate the prevalence of Hhcy in postmenopausal women in the city of São Paulo, as well as to evaluate the association of Hcy levels with lipid profile, hot flushes and subjective sleep parameters.


This research is part of the São Paulo Sleep Epidemiological Study (EPISONO), a population-based cross-sectional trial that included 1,042 volunteers living in the city of São Paulo in 2007. All volunteers underwent blood sample collection for lipid profile analysis (Blood samples were collected for Hcy, total cholesterol, HDL, LDL, triglycerides) and filled out a set of sleep-related questionnaires (Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale were used). Women were classified as recent or late postmenopause according to the time of amenorrhea. Less than eight years recent. More than eight years late. The GzLM (Generalized Linear Model) was used to verify the association between the different variables. Dependent variables were used in binominal and gama distribution when needed. Study approved by the Ethics Committee (CEP #0593/06) and registered with (NCT00596713).


The sample consisted of 193 postmenopausal women, with a mean age of 58 years (SD ± 9). The prevalence of Hhcy in this sample was 4.7%, while 14.7% had dyslipidemia 22.8% with hypertriglyceridemia and 29% with low HDL levels. There was an association between Hcy and HDL. There was no association between Hcy and hot flushes, Hcy and LDL, nor with Hcy and sleep parameters.


The studied population presented low prevalence of Hhcy and there was no association between Hcy and sleep parameters.

Acknowledgments: to funding agencies, CAPES, AFIP.


Menopause; Postmenopause; Homocysteine; Women; Sleep


Área Clínica


Santa Casa de São Paulo School of Medical Sciences - Sao Paulo - Brasil


Carolina Vicente Banzoli, Andréia Gomes Bezerra, Vânia DAlmeida, Gabriel Natan Pires, Monica Levy Andersen, Sergio Tufik, Helena Hachul