In this issue of THE JOURNAL, 2 meta-analyses critically review the
coronary heart disease (CHD) risks related to blood levels of homocysteine
and a common variant of methylene tetrahydrofolate reductase (MTHFR), a gene that is known to be an important regulator of homocysteine
metabolism.1,2 The authors summarize
data on the potential effects of this genetic variant and plasma homocysteine
levels on CHD risk and conclude that the risks are increased modestly. While
the authors do not recommend new approaches to evaluate persons at risk for
CHD, the study findings do provide a perspective on how scientists assess
the utility of newer biomarkers and genetic factors that may contribute to
CHD risk.