Hyperhomocysteinemia as a Predictive Biomarker for Impaired Diffusion Capacity of the Lung for Carbon Monoxide

Abstract

SESSION TITLE: Pulmonary Physiology Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: Research has suggested that Hyperhomocysteinemia increased the risk of thrombus formation, by irritating the linings of the blood vessels. Although Hyperhomocysteinemia is considered as a cardiovascular predictive biomarker but none of the studies have examined its role as a pulmonary risk factor. The purpose of the study was to describe the association of Hyperhomocysteinemia with pulmonary diffusion capacity. METHODS: Four hundred study subjects were randomly selected in an outpatient clinic in Texas. Demographic, laboratory and clinical information including co-morbid conditions (OSA, hypertension, diabetes, cardiac diseases) and measurement of the diffusion capacity for carbon monoxide (DCLCo) were obtained for each patient. Standard descriptive and logistic regression techniques were employed with outcome variable as impaired lung diffusion (DCLCo less than 70%) and predictor variable hyperhomocysteinemia (homocysteine >12μmol/L). RESULTS: 160 patients (41%) with impaired lung diffusion for CO were mostly older (74% older than 65), females, nonsmoker, and obese (62%). Out of these, 14.2% have mild, 10.5 moderate and 17.7% have severely impaired lung diffusion. Unadjusted logistic regression reveals high homocystein levels are associated with impaired lung diffusion capacity (OR 2.54, P=0.01). Multivariate analysis after controlling for age, gender, ethnicity and comorbid conditions indicated that Hyperhomocysteinemia is significantly associated with lung diffusion capacity impairment (OR 2.50, P=0.03). In asthmatic patients, association of Hyperhomocysteinemia and lung diffusion was statistically significant (OR 2.30, P=0.02); in nonasthmatic, the Hyperhomocysteinemia and DCLCo correlation was not significant. (OR 1.21, P=0.71) CONCLUSIONS: Hyperhomocysteinemia is associated with impaired lung diffusion in adult patients and specifically for those who were asthmatic. CLINICAL IMPLICATIONS: Risk-identification in specific patient population will improve the quality of customized care and dissemination of relevant information about co-morbid conditions as an additional health risk to the patients, which will result in early prevention and improved patient's outcomes. DISCLOSURE: The following authors have nothing to disclose: Gul Nowshad, Mohamad Ayass No Product/Research Disclosure Information