Abstract
Objectives:Hyperhomocysteinemia has been considered as a potential risk factor for deep venous thrombosis (DVT) but it is still controversy. We aimed to evaluate the prevalence of hyperhomocysteinemia in patients with DVT. Our second objective was to document the prevalence of folate, Vitamin B6, and Vitamin B12 level in this patient population.Methods:Sixty patients with DVT aged from 23 to 84 years, were assessed regarding demographic characteristics, serum levels of homocysteine, folate, vitamin B12, and vitamin B6. The diagnosis of DVT was based upon Wells scoring system and serum D-dimer level and confirmed by deep venous Doppler ultrasonography of the lower limbs.Results:Mean serum homocysteine levels were found significantly higher in patients over the age of 40 years (10.81±4.26 µmol/L vs 9.13±3.23 µmol/L). Of all the patients, 9 patients had homocysteine level above the 15µmol/L, 26 had folic acid level below 3 ng/ml, one had vitamin B12 level below 150 pmol/L, and two had vitamin B6 level below 30 nmol/L. In the hyperhomocysteinemic group, five patients had low folic acid level, one had low vitamin B12 level, and two had low vitamin B6 level.Conclusions:Hyperhomocysteinemia, in women older than 40 years, may be a risk factor for DVT. Folic acid deficiency may also influence serum homocysteine concentrations. Folate therapy may be offered to the patients with DVT. However further studies are required to clarify the underlying molecular mechanisms.
Highlights
Venous thromboembolism (VTE) is the third most common vascular disease after myocardial infarction and ischemic stroke
Homocystein is a nonessential amino acid containing sulfur that is formed by demethylation pathway of the methionine, which is dependent on vitamins as cofactors or cosubstrates.[8,9]
Homocysteine is synthesized by two metabolic pathways
Summary
Venous thromboembolism (VTE) is the third most common vascular disease after myocardial infarction and ischemic stroke. It is well known that, individual coagulation factors are the best markers of venous thrombotic risk and, in part up to 50% determined by genetic factors. Lifestyle and environmental factors have effect on thrombotic events.[1]. Hyperhomocysteinemia is a disorder of methionine metabolism and proposed to be a modifiable risk factor of myocardial infarction, peripheral arterial thrombosis as well as deep vein thrombosis and pulmonary embolism.[2] Most of the reports related to arterial disease associated with mildly increased homocysteine level. There are limited and conflicting publications related to venous system thrombosis associated with homocysteine level.[3]
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