Elevated homocysteine as an independent risk for intracranial atherosclerotic stenosis.

Ying Liu,Lan Tan,Xue-Ning Shen,Jing-Hui Song,Ya-Hui Ma,Wei Xu,Jin-Tai Yu,Song Chi,Xiao-He Hou,Qiang Dong,Fu-Rong Sun

doi:10.18632/aging.102019

Abstract

To investigate the association of homocysteine concentration with intracranial atherosclerotic stenosis (ICAS), we assessed 933 acute ischemic stroke patients (346 with ICAS, 587 without ICAS) and 798 non-stroke controls (175 with ICAS, 623 without ICAS) with magnetic resonance angiography (MRA). Homocysteine concentration was found to be significantly higher in participants with ICAS than those without ICAS. In logistic regression analyses, homocysteine concentration was significantly associated with ICAS both in patients (OR: 1.04; 95% CI: 1.01–1.08; P=0.008) and controls (OR: 1.10; 95% CI: 1.06–1.15; P<0.001) for 1 μmol/L increment in homocysteine. Compared with the lowest quartile, the second (OR:1.53; 95% CI: 1.01-2.33), third (OR:1.71; 95% CI: 1.14 -2.60) and fourth (OR:2.48; 95%CI: 1.63-3.81) quartiles were independent predictors of ICAS in patients (P for trend<0.001); the third (OR:1.99; 95% CI: 1.18-3.40) and fourth (OR:2.36; 95%CI: 1.38-4.10) quartiles were independent predictors of ICAS in controls (P for trend<0.001). Hence, elevated homocysteine might be an independent risk for ICAS.

Highlights

Stroke has become one of the leading causes of death and disability in China despite the obvious improvement in life expectancy [1]
HHcy was found to be associated with poor prognosis, mortality and neurological deterioration after stroke [10,11,12,13,14], especially in the population with large-vessel atherosclerosis [15, 16], which implied the potential role of Hcy in prowww.aging-us.com atherosclerotic process
1731 participants were included in the study, among whom 933(53.90%) were ischemic stroke patients and 798(46.10%) were controls

Summary

Introduction

Stroke has become one of the leading causes of death and disability in China despite the obvious improvement in life expectancy [1]. Intracranial atherosclerotic stenosis (ICAS) is the most common cause of stroke in Asian population and is estimated to account for 33% to 50% of ischemic stroke in China [2]. Some studies suggested that Hcy was a risk factor of special subtypes of stroke as it was prone to be higher in stroke with large-artery atherosclerosis [8, 9]. Most studies focus on the association between stroke and Hcy according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria [15,16,17,18], with few and inconsistent conclusions on ICAS involving Hcy. Some studies demonstrated that patients with HHcy had severer stenosis and more arterial lesions in the intracranial arteries [19,20,21]. Another study found that HHcy had no effect on extracranial and intracranial large arteries [23]

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