• deep vein thrombosis;
  • epidemiology;
  • homocysteine;
  • MTHFR;
  • pulmonary embolism


We sought to examine prospectively the association of serum homocysteine and the methylene tetrahydrofolate reductase (MTHFR) C677T gene polymorphism with risk of venous thromboembolism (VTE). We studied these relationships in a nested case–control study of 303 VTE cases and 635 matched controls from a population-based cohort of 21,680 adults from six U.S. communities. The highest quintile of serum homocysteine carried a non-statistically significant adjusted odds ratio of 1.55 (95% CI, 0.93–2.58) compared to the lowest quintile in the overall cohort but a significant association among adults aged 45–64 years (OR = 2.05, 95% CI, 1.10–3.83) and an inverse association in those ≥65 years of age. Carriers of the MTHFR C677T polymorphism were not at higher risk for VTE than those with normal genotype (OR = 0.74, 95% CI = 0.56–0.98). Our prospective data showed, at most, a weak relationship between homocysteine and VTE risk, with associations larger among younger participants. MTHFR C677T was not a risk factor for VTE. Am. J. Hematol. 72:192–200, 2003. © 2003 Wiley-Liss, Inc.