Relationship between plasma glutathione levels and cardiovascular disease in a defined population: the Hisayama study.

BACKGROUND AND PURPOSE Glutathione (GSH) appears to have marked antioxidant activities and therefore may prevent cardiovascular disease (CVD). However, there are very few reports on this subject. In a community-based case-control study, we tested the hypothesis that low levels of plasma GSH are closely associated with CVD and its clinical types. METHODS The association between fasting plasma total GSH (tGSH) levels and CVD were assessed using conditional logistic regression analysis among 134 CVD cases and 435 age- and sex-matched healthy control subjects. RESULTS Mean tGSH concentrations were lower in all CVD cases than in the control subjects (3.06 versus 3.71 micromol/L; P=0.0001). Among the CVD types, both the cerebral infarction cases (2.98 versus 3.59 micromol/L; P=0.001) and cerebral hemorrhage cases (2.51 versus 3.43 micromol/L; P=0.0027) had significantly lower tGSH levels than the corresponding control groups had. The same tendency was observed for cases of subarachnoid hemorrhage (3.45 versus 3.83 micromol/L; P=0.36) and myocardial infarction (3.65 versus 3.77 micromol/L; P=0.69), but these differences were not statistically significant. After adjustment for other confounding factors, the risk of CVD was significantly lower in the third (adjusted odds ratio, 041; 95% CI, 0.21 to 0.77) and the fourth quartiles (adjusted odds ratio, 0.25; 95% CI, 0.12 to 0.51) than in the first. This association was most prominent in patients with lacunar infarction or cerebral hemorrhage. CONCLUSIONS These findings suggest that reduced plasma tGSH levels are a risk factor for CVD, especially for cerebral small vessel disease.