Elevated Serum Homocysteine Research Articles

Factors associated with fetal karyotype in spontaneous abortion: a case-case study

BackgroundMost embryos that spontaneously abort during early pregnancy are found to have chromosomal abnormalities. The purpose of this study is to explore the factors involved in chromosome aberrations during embryogenesis.MethodsA case-case study was performed to compare the risk factors for spontaneous abortion with and without embryo chromosome aberration. A total of 160 cases of spontaneous abortion were enrolled from a tertiary general hospital in Kunming. KaryoLite BACs-on-Beads (KL-BoBs) and fluorescence in situ hybridization (FISH) were employed to determine chromosomal constitution of abortion chorion villus samples. Maternal serum levels of homocysteine (Hcy) were detected by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Information about clinical background and environmental exposure was collected through a self-designed questionnaire. To identify the inherited chromosomal abnormalities, couples with chromosomal abnormalities in abortus were recalled for karyotyping.ResultsThe overall rate of chromosomal abnormalities was 62.5% (100/160, KL-BoBs combined with FISH) including 51.9% (83/160) aneuploidies, 6.3% (10/160) polyploidies, and 4.4% (7/160) structural abnormalities. Only one case of structural abnormality was found to be inherited from maternal balanced translocation. Compared to abortus with normal karyotype, abortus with abnormal karyotype showed a positive association with parental age and elevated maternal serum homocysteine (Hcy) level, but negative association with previous miscarriage and perceived noise.ConclusionsEmbryonic chromosomal aberrations accounted for the majority of spontaneous abortion cases. A combination of internal and external factors may induce spontaneous abortion through fetal chromosomal aberrations or other pathogenic mechanisms.

Development and validation of a prediction model of deep venous thrombosis for patients with acute poisoning following hemoperfusion: a retrospective analysis.

ObjectiveTo develop and confirm an individualized predictive model to ascertain the probability of deep venous thrombosis in patients with acute poisoning after undergoing hemoperfusion.MethodsThree hundred eleven patients with acute poisoning who were admitted to a hospital in China between October 2017 and February 2019 were included in the development group. Eighty patients with acute poisoning who were admitted between February and May 2019 were included in the validation group. The independent risk factors for deep venous thrombosis were examined. An individualized predictive model was developed using regression coefficients.ResultsThe number of catheter indwelling days, having a catheter while being transported, elevated serum homocysteine concentrations, and dyslipidemia were independent risk factors for deep venous thrombosis following hemoperfusion in patients with acute poisoning. The areas under the receiver operating characteristic curve of the development and validation groups were 0.713 and 0.702, respectively, which suggested that the prediction model had good discrimination capacity. The calibration belts of the two groups were ideal.ConclusionsOur prediction model has a moderate predictive effect for the occurrence of deep venous thrombosis in patients with acute poisoning. In clinical practice, this model could be combined with a common thrombosis risk assessment model.

Elevated serum homocysteine levels are associated with the development of chronic venous ulcers

Venous ulceration is a multifactorial disease, and whether hyperhomocysteinemia (HHcy) promotes deterioration from primary varicose veins to venous ulcers remains unproven. This study retrospectively analyzed clinical data from 717 patients to investigate the potential correlation between HHcy and primary varicose veins ulcer formation, including 611 patients without ulcers (control group) and 106 with ulcers (case group). In this study, 46.2% (49/106) of patients in the case group and 17.5% (107/611, p < 0.001) in the control group suffered from HHcy. Multivariate logistic analysis revealed that HHcy was closely associated with the incidence of venous ulceration in patients with primary varicose veins (p < 0.001). Propensity score matching created 101 matched pairs of patients with and without ulcers, and the analysis pointed to a potential link between HHcy and ulcer formation in the context of primary varicose veins (p < 0.001). Additional experiments showed that HHcy could induce endothelial dysfunction and phenotypic switching of vascular smooth muscle cells. Both clinical and experimental findings implicated HHcy as a key factor in the development of venous ulceration. Further research is needed to appraise the effectiveness of HHcy-lowering therapy in the prevention of venous ulcers in patients with varicose veins.

FABP4 activates the JAK2/STAT2 pathway via Rap1a in the homocysteine-induced macrophage inflammatory response in ApoE−/− mice atherosclerosis

AbstractAtherosclerosis is a chronic inflammatory vascular disease, and inflammation plays a critical role in its formation and progression. Elevated serum homocysteine (Hcy) is an independent risk factor for atherosclerosis. Previous studies have shown that fatty acid binding protein 4 (FABP4) plays an important role in macrophage inflammation and lipid metabolism in atherosclerosis induced by Hcy. However, the underlying molecular mechanism of FABP4 in Hcy-induced macrophage inflammation remains unknown. In this study, we found that FABP4 activated the Janus kinase 2/signal transducer and activator of transcription 2 (JAK2/STAT2) pathway in macrophage inflammation induced by Hcy. Of note, we further observed that ras-related protein Rap-1a (Rap1a) induced the Tyr416 phosphorylation and membrane translocation of non-receptor tyrosine kinase (c-Src) to activate the JAK2/STAT2 pathway. In addition, the suppressor of cytokine signaling 1 (SOCS1)—a transcriptional target of signal transducer and activator of transcription (STATs) inhibited the JAK2/STAT2 pathway and Rap1a expression via a negative feedback loop. In summary, these results demonstrated that FABP4 promotes c-Src phosphorylation and membrane translocation via Rap1a to activate the JAK2/STAT2 pathway, contributing to Hcy-accelerated macrophage inflammation in ApoE−/− mice.

A cross-sectional study of comparison of elevated levels of serum Homocysteine in intracranial and extracranial atherosclerotic stenosis groups.

Introduction: The primary goal of this study was to compare serum homocysteine levels in acute ischemic strokes caused by extracranial atherosclerotic stenosis (ECAS) and intracranial atherosclerotic stenosis (ICAS)groups in order to see if there was a link between elevated serum homocysteine levels and ICAS. Methodology: The present study was a cross-sectional study done by the department of neurology at a tertiary level hospital in Mumbai. Various clinical, radiological &amp; laboratory parameters including serum Homocysteine were compared between patients with ECAS and ICAS stroke. Results: The study enrolled a total of 150 patients, with 110 in the ECAS group and 40 in the ICAS group. We observed that mean serum Homocysteine levels were 2.42 µg/ml in the ECAS group and 4.88 µg/ml in the ICAS group (p=0.01). High serum Homocysteine levels were more common in the ICAS group than in the ECAS group (55 percent versus 33.6 percent, p = 0.01). The lipid profile was found to be similar in the two study groups, except for low HDL, which was observed in 70 (64%) of the ECAS patients as compared to 17 (43%) of the ICAS (p-value &lt; 0.05). There was no statistical difference in the caparison of demographic and other risk factor profiles between ECAS and ICAS patients. Conclusions: High serum Homocysteine levels were found to be more common in the ICAS group than in the ECAS group.

Role of mutations in MTHFR gene and hyperhomocysteinemia in occurrence of ischemic stroke

The objective of the study is review and analyze scientific publications devoted to the problems of stroke, its relationship with the most common mutations in the MTHFR gene and their individual allelic variants and serum homocysteine levels.Materials and methods. Analyzing foreign and domestic publications, the relationship of the strongest mutations in the MTHFR gene with an increase in the level of serum homocysteine, which is a predictor of the development of vascular accidents, including acute circulatory disorders of the brain, was revealed.Results. Stroke is a socially significant disease. All risk factors for acute cerebral stroke are subdivided into modifiable and non-modifiable. To a non-modifiable factor that predisposes to the development of ischemic and hemorrhagic stroke, hereditary factors, including genetic mutations in a number of genes. MTHFR is a genome carrying individual allelic variants that can affect the level of homocysteine in blood serum, causing it to increase, and hyperhomocysteinemia, according to a number of studies, is a likely predictor of diseases of the cardiovascular system, including severe cerebrovascular accidents. At the same time, a large number of studies use the services of the protective role of reducing the elevated level of serum homocysteine using various forms of folic acid and B vitamins. The authors of the article attempted to process, analyze and summarize the data of modern research issues on the topic under consideration.Conclusions. The relationship between the occurrence of ischemic and hemorrhagic stroke and the most common mutations in the MTHFR gene has been revealed. Hyperhomocysteinemia, separate and developing as a result of these mutations, is an independent risk factor for the development of acute cerebral ischemia. Normalization of elevated serum homocysteine levels is required for all patients as stroke prevention, and includes not only the use of foods enriched with folic acid, but also pharmacological correction of folates and B vitamins.

The Effects of Vitamin Supplementation Containing L-Methylfolate (Ocufolin® forte) on Retinal Venous Pressure and Homocysteine Plasma Levels in Patients with Glaucoma

# Purpose To report our observations of the effects of Ocufolin® forte on elevated retinal venous pressure (RVP) and elevated serum homocysteine (Hcy) in patients with glaucoma and/or ocular vascular diseases. # Methods A total of 26 patients with glaucoma and/or ocular vascular diseases in at least one eye, abnormal steady-state pattern electroretinography, RVP measured using an ophthalmodynamometer at least 15 mmHg higher than intra-ocular pressure (IOP), fasting serum Hcy level >12 µmol/l and stable and well-controlled IOP (with or without IOP-lowering treatment) received supplementation with Ocufolin® forte for 3 months. # Results As additional treatment was needed in 2 patients their results were excluded from analysis. In the remaining 24 patients, 42 eyes of 21 patients qualified for RVP analysis. Mean IOP remained stable (p=0.15) during the study, but mean RVP dropped by 8.8 mmHg (p<0.001), from 28.1±11.7 mmHg at pre-supplementation to 19.3±7.4 mmHg at 3 months. In 22 of the 24 patients, serum Hcy was analyzed again between 3 days and almost 41 weeks after cessation of supplementation. Serum Hcy levels dropped from 15.8±2.8 µmol/l before to 12.51±2.90 µmol/l after supplementation (p<0.001). # Conclusions In this pilot study, Ocufolin® forte had a clinically relevant and statistically significant RVP lowering effect and led to a clinically relevant and statistically significant Hcy decrease, offering a new treatment modality for eye diseases with increased RVP, such as glaucoma.

Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018.

A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ⩾ 15.0µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY 15.0µmol/L). Finally, 110 551 residents ⩾ 40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9µmol/L (interquartile range 7.9-15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338-2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

Endothelial Dysfunction and Hyperhomocysteinemia-Linked Cerebral Small Vessel Disease: Underlying Mechanisms and Treatment Timing.

Cerebral small vessel disease (cSVD)—a common cause of stroke and vascular dementia—is a group of clinical syndromes that affects the brain's small vessels, including arterioles, capillaries, and venules. Its pathogenesis is not fully understood, and effective treatments are limited. Increasing evidence indicates that an elevated total serum homocysteine level is directly and indirectly associated with cSVD, and endothelial dysfunction plays an active role in this association. Hyperhomocysteinemia affects endothelial function through oxidative stress, inflammatory pathways, and epigenetic alterations at an early stage, even before the onset of small vessel injuries and the disease. Therefore, hyperhomocysteinemia is potentially an important therapeutic target for cSVD. However, decreasing the homocysteine level is not sufficiently effective, possibly due to delayed treatment, which underlying reason remains unclear. In this review, we examined endothelial dysfunction to understand the close relationship between hyperhomocysteinemia and cSVD and identify the optimal timing for the therapy.

A POSSIBLE RELATIONSHIP BETWEEN SERUM HOMOCYSTEINE LEVEL AND IgA NEPHROPATHY IN CHILDREN

Objective: The evidences from experimental and epidemiological studies suggests that elevated serum homocysteine levels may lead to renal injury and may be a significant risk factor for the development of chronic kidney disease. The aim of this study was to investigate a possible relationship between serum homocysteine level and crescent formation in children with IgA nephropathy and Henoch-Schonlein purpura nephritis. Material and Methods: A total of 31 patients diagnosed as biopsy proven IgA nephropathy and Henoch-Schonlein purpura nephritis and idiopathic crescentic glomerulonephritis in three Pediatric Nephrology centers within the last five years and 25 healthy controls were enrolled in the study. Results: Homocysteine levels of patients were higher than the upper limit of normal value and also higher than the controls (p=0.0001). There was no significant difference between the patients with or without crescent formation regarding homocysteine levels (p&gt;0.05). Presence or severity of proteinuria was not related to homocysteine levels (p&gt;0.05). Conclusion: Serum homocysteine levels are elevated in patients with IgA nephropathy and Henoch-Schonlein purpura nephritis.&nbsp;Our results suggest that elevated serum homocysteine levels may be related to segmental glomerulosclerosis in these patient groups.

Независимые факторы сердечно-сосудистого риска: гипергомоцистеинемия и жесткость сосудов у больных с артериальной гипертензией

Актуальность. Определение факторов риска и проведение предварительной оценки общего сердечно-сосудистого риска (ССР) у пациентов с артериальной гипертензией (АГ) — самая важная задача в клинической практике. У большинства пациентов, помимо повышенного артериального давления (АД), отмечаются и другие факторы ССР, усиливающие друг друга, что приводит к увеличению общего ССР. Одним из факторов ССР является жесткость артерий. Определение жесткости артерий проводят с помощью метода определения скорости распространения пульсовой волны (СРПВ). Вторым независимым фактором риска развития сердечно-сосудистых заболеваний является повышенный уровень гомоцистеина (ГЦ) в крови. Цель: оценить связь гипергомоцистеинемии (ГГц) с жесткостью сосудов у пациентов с АГ. Материалы и методы. Наше исследование было выполнено в рамках исследования ХИПСТЕР в Украине. В исследование было включено 40 пациентов с I и II степенью АГ (средний уровень офисного систолического (САД)/диастолического АД — 155,88/92,60 ± 1,63/1,43 мм рт.ст.), частота сердечных сокращений — 71,40 ± 1,29 уд/мин. Средний возраст больных составил 55,85 ± 2,09 года (26–74). Пациентов с уровнем ГЦ ≥ 10 мкмоль/л определяли как пациентов с ГГц (Н-тип АГ). Жесткость сосудов определяли по СРПВ. Результаты. Нами выявлено, что в начале исследования 75% (30 пациентов с мягкой и умеренной АГ) имели Н-тип АГ с повышенным уровнем ГЦ. Пациенты с Н-типом АГ (ГГц) и АГ без ГГц не отличались по возрасту, длительности АГ. При этом пациенты с Н-типом АГ имели большие массу тела, индекс массы тела (ИМТ). Офисное САД у пациентов с Н-типом АГ в начале и через 6 месяцев лечения было выше по сравнению с пациентами без ГГц (156,45 ±1,04 мм рт.ст. против 152,55 ± 1,41 мм рт.ст. в начале (р &lt; 0,05) и 130,65 ± 0,96 мм рт.ст. против 126,97±1,08мм рт.ст. через 6 месяцев (р &lt; 0,05)). ИМТ в начале исследования с Н-типом АГ — 30,72 ± 0,39 кг/м2 против 28,34 ± 0,69 кг/м2 без ГГц (р &lt; 0,05). Пациенты с Н-типом АГ хуже достигали целевых уровней АД на фоне лечения, и у них изначально были высокие показатели АД. Пациенты с Н-типом АГ по сравнению с пациентами без ГГц имели более выраженную степень инсулинорезистентности (по уровню индекса НОМА), меньшую скорость клубочковой фильтрации как в начале, так и в конце лечения. По данным суточного мониторирования АД до начала лечения пациенты с Н-типом АГ по сравнению с пациентами с АГ без ГГц имели достоверно более высокий уровень САД. После регрессионного анализа уровень гомоцистеина ассоциировался со СРПВ по артериям эластичного типа (СРПВэл) независимо от степени снижения АД (СРПВэл (6 месяцев), м/с, β = 0,307, Р = 0,001). Выводы. Мужской пол, индекс массы тела, скорость клубочковой фильтрации, уровень глюкозы крови, уровень офисного и центрального артериального давления ассоциировались с повышением уровня гомоцистеина крови у пациентов с артериальной гипертензией.

A Complicated Case of Stroke, Epilepsy, and Mood Disorder: Hyperhomocysteinemia or Medication Cascade

Introduction: Hyperhomocysteinemia is a risk factor for atherosclerosis and vascular disease, which is correlated with cerebral problems and various neurological disorders. Case presentation: We report a 20-year-old lady with a history of hyperhomocysteinemia affected with stroke, seizure, and mood disorder. By initiating medication for these illnesses, different complications appeared. During the hospital stay, drugs for treating a disease deteriorated the other. We encountered a complex patient and numerous ambiguities in her management. Conclusions: For patients with elevated serum homocysteine and psychiatry disorders, it is important to consider MTHFR gene mutation. A challenge in these patients is to select the medication that does not deteriorate hyperhomocysteinemia. In this complex case, we used carbamazepine that was accompanied by clinical improvement.

Association of blood levels of homocysteine, vitamin B12, and serum cholesterol with age related macular degeneration in the elderly population of India

Title: Association of blood levels of homocysteine, vitamin B12, and serum cholesterol with age related macular degeneration in the elderly population of India.Aim: To determine any association of Age related macular degeneration (ARMD) with blood levels of homocysteine, vitamin B12, and serum cholesterol. Methods: The levels of homocysteine, vitamin B12, and serum cholesterol in patients who were diagnosed with Age related macular degeneration (ARMD) in either eye (n=109) were compared to a control group with no retinal pathology (n=134). Diabetic patients were excluded from the study.Results: Raised serum cholesterol levels were more common in ARMD cases (47.5%) compared to controls (28.4%). This association was found to be statistically significant (p<0.01). Levels of serum homocysteine were higher in the ARMD group than in the control group whereas serum vitamin B12 levels were lower in the ARMD group than in the control group but was not statistically significant (p=0.68 and p=0.51).Serum homocysteine level was significantly higher in males compared to females in both case and controls (p<0.01).Conclusion: Raised serum cholesterol levels were significantly associated with increased risk of age related macular degeneration.Our study did not find elevated serum homocysteine or low serum vitamin B12 as significantly associated with age related macular degeneration.

Frequency of Elevated Homocysteine Levels in Patients with Ischemic Stroke

Objective: To determine the frequency of elevated homocysteine levels in patients with ischemic stroke. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine Unit II, Jinnah Hospital, Lahore from 13th October 2017 to 12th April 2018. Methodology: Two hundred and fifty subjects of ischemic cerebral stroke were included in this study using non probability sampling technique. Diagnosis of ischemic stroke was confirmed by CT brain and serum homocysteine level was measured in micromoles/L. Results: The average age of our studied population was 64.9±11.5 years with 141 males (56.4%) and 109 (43.6%) females. Mean total homocysteine levels were 55.5±2.9 μm/L and the range was 8-148.7. Elevated homocysteine levels were found in 239 (95.6%) and were normal in 11 (4.4%). Highly elevated levels were present in 18 (7.5%), moderately elevated in 179 (74.9%) and lightly elevated levels were found in 82 (17.6%). Conclusion: The elevated homocysteine levels are a strong risk factor for ischemic cerebral Stroke. About 74.9% of the patients with ischemic stroke had moderately elevated levels whereas 7.5% had highly elevated serum homocysteine levels. Key words: Ischemic stroke, Elevated homocysteine levels

Persistent Helicobacter pylori infection for more than 3years leads to elevated serum homocysteine concentration: A retrospective cohort study based on a healthy Chinese population.

The relationship between the Helicobacter pylori (H. pylori) infection and homocysteine is unclear. We evaluated the effect of H. pylori on serum homocysteine in a healthy Chinese population. A total of 21184 individuals aged over 18years underwent 13 C/14 C urease breath test (13 C/14 C-UBT) and blood tests and 5042 individuals with follow-up intervals greater than 6months. Homocysteine levels are classified according to the Chinese expert consensus. The rates of H. pylori infection of normal level, mild level, moderate level, and severe level were 40.9%, 43.8%, 45.8%, and 46.6%, respectively (P=0.000). H. pylori infection increased the risk of higher homocysteine concentration (OR=1.406, P=0.000). In the case-control study, the rates of persistent negative, new infection, persistent infection, and eradication infection were 43.6%, 11.2%, 22.9%, and 22.3%, respectively. The percentage of changes in serum homocysteine levels varied significantly among the different H. pylori infection statuses only in mild level (P=0.024). Mean changed homocysteine values were higher in the subgroup of persistent infection than in the persistent negative subgroup (P=0.004) and the eradication infection subgroup (P=0.034). Serum homocysteine values were elevated only in the subgroup with over 3years interval time and persistent infection (n=107, mean paired differences=1.1±4.6μmol/L, P=0.014). There is a relationship between H. pylori and serum homocysteine, and persistent infection leads to elevation of the latter.

Study on Homocysteinemia as a Risk Factor of Ischemic Stroke

Despite recent advances, only two-third of all strokes can be attributed to known causal risk factors. Homocysteine (tHcy), a sulfur-containing amino acid, is now considered to be an important risk factor for vascular diseases, along with the established risk factors like hyperlipidemia, hypertension, diabetes mellitus, and smoking. Elevated homocysteine levels play a causal role in the pathogenesis of atherosclerosis, thromboembolism and vascular endothelial dysfunction with an increased incidence of ischemic stroke. This study aimed to find out the association of hyperhomocysteinemia with ischemic stroke. A total of 100 subjects were included in this study, 50 were ischemic stroke patients enrolled as case, and 50 were normal healthy individuals enrolled as control. Serum homocysteine level was measured in both case and control groups. The comparison was made in both groups regarding other common risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, family history, etc. Among 100 patients, 50 had ischemic stroke and 50 were healthy individuals. In this study, out of all patients, abnormal serum homocysteine level was found in 32% of cases and 12% of controls. The mean (±SD) serum homocysteine level was found 16.50±13.86 μmole/L in cases and 9.46±3.49 μmole /L in the control group. Significant (p&lt;0.05) difference was found between the case and the control. The incidence of hyperhomocysteinemia is higher in ischemic stroke cases than that in age-sex-matched healthy controls. In our study, serum homocysteine was high in both younger age group patients (16.65±14.55 μmole/L vs. 9.52±3.19 μmole/L) and older age group patients (16.33±9.87 vs. 9.35±3.97 μmole/L,) in case and control group respectively. Significant (p&lt;0.05) difference was found between the case and the control. Multiple logistic regression analysis showed that abnormal serum homocysteine is an independent risk factor of ischemic stroke. So we conclude that hyperhomocysteinemia is an important and independent risk factor for the development of ischemic stroke. Hypertension and smoking are important contributory to elevated serum homocysteine.&#x0D; TAJ 2021; 34: No-1: 33-39

Letrozole-Induced Polycystic Ovary Syndrome Attenuates Cystathionine-β Synthase mRNA and Protein Abundance in the Ovaries of Female Sprague Dawley Rats.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 10% of reproductive-aged women and leads to hyperandrogenism, anovulation, and infertility. PCOS has been associated with elevated serum homocysteine as well as altered methylation status; however, characterization of one-carbon metabolism (OCM) in PCOS remains incomplete. The aim of our research was to assess OCM in a letrozole-induced Sprague Dawley rat model of PCOS. Five-week-old female rats (n=36) were randomly assigned to letrozole [0.9mg/kg body weight (BW)] treatment or vehicle (carboxymethylcellulose) control that was administered via subcutaneously implanted slow-release pellets every 30 d. For both treatment groups, 12 rats were randomly assigned to be euthanized during proestrus at one of the following time points: 8, 16, or 24 wk of age. Daily BW was measured and estrous cyclicity was monitored during the last 30 d of the experimental period. Ovaries were collected to assess mRNA and protein abundance of OCM enzymes. Letrozole-induced rats exhibited 1.9-fold higher cumulative BW gain compared with control rats across all age groups (P <0.0001). Letrozole reduced the time spent at proestrus (P=0.0001) and increased time in metestrus (P<0.0001)of the estrous cycle. Cystathionine β-synthase (Cbs) mRNA abundance was reduced in the letrozole-induced rats at 16 (59%; P <0.05) and 24 (77%; P <0.01) wk of age. In addition, CBS protein abundance was 32% lower in 8-wk-old letrozole-induced rats (P=0.02). Interestingly, betaine-homocysteine S-methyltransferase mRNA abundance increased as a function of age in letrozole-induced rats (P=0.03). These data demonstrate that letrozole-induced PCOS Sprague Dawley rats temporally decrease the ovarian abundance of Cbs mRNA and protein in the early stages of PCOS.

Role of thrombophilia testing in retinal vein occlusion: single centre experience from Oman

Thrombophilia is a known predisposition to venous thromboembolism however there was no significant relationship with retinal vein occlusion (RVO). Herein, we aimed to study the prevalence of thrombophilia among Omani patients presented with RVO. In a retrospective study, 11 consecutive patients diagnosed by the ophthalmologists at Armed Forces Hospital with RVO (central RVO, n=7; branch RVO, n=4) were included. Thrombophilia testing including factor V Leiden, Prothrombin gene mutation (G20210A) and Janus Kinase-2 (JAK2 V617F) mutation analysis; presence of autoantibodies including Anti-nuclear antibody(ANA), Anti-neutrophil cytoplasmic antibody (ANCA), Lupus anticoagulant (LA), Anti-cardiolipin antibody (ACA), Anti-B2 glycoprotein positivity; abnormal coagulation protein levels including protein S, Protein C, Anti-thrombin and Factor VIII as well as biochemical parameters like elevated serum lipoprotein 1a, triglycerides, total cholesterol and homocysteine levels were performed. Patient’s ages ranged between 25 to 75 years (mean + SD; 48.8 + 13.6) with a mild male preponderance (54.5%). None of them gave history of smoking. However, 27.3% and 45.5% had history of diabetes and hypertension, respectively. Amongst the thrombophilia tests evaluated, only one patient was positive for an underlying Prothrombin gene (G20210A) heterozygosity, another patient was positive for Anti-beta2 glycoprotein antibody and one patient with high serum homocystine. Our study demonstrated that thrombophilia is not prevalent in omani patients diagnosed with RVO in the armed forces hospital. Furthermore, 27.3% and 45.5% of those patients were suffering from diabetes and hypertension, respectively which are known risk factors for RVO.

Elevated Serum Homocysteine Associated with Distal Type of Single Small Subcortical Infarction.

The aim of this investigation was to examine the association between the serum homocysteine (Hcy) level and the distal single small subcortical infarction (dSSSI). Consecutive patients were prospectively recruited in a registered hospital-based ischemic stroke database. Baseline characteristics and risk factors of single small subcortical infarction (SSSI), including the serum Hcy level, were assessed. The SSSI located in the lenticulostriate artery (LSA) territory was divided into proximal single small subcortical infarction (pSSSI) and dSSSI based on a standard template on axial diffusion-weighted imaging (DWI). The association between the serum Hcy level and dSSSI was analysed by multivariate logistic regression analysis. Out of 3,247 patients, a total of 572 patients were included in the final analysis. We found that dSSSI had a higher serum Hcy level than pSSSI. Elevated Hcy level was independently correlated with dSSSI. Compared with the lowest quartile, the upper quartiles of Hcy level were independently associated with dSSSI, the odds ratio for the second quartile was 1.748 (95%CI 1.019 to 3.000), 1.824 (95% CI 1.060 to 3.140) for the third quartile, and 2.010 (95% CI 1.155 to 3.497) for the fourth quartile. The restricted cubic spline showed that the higher level of Hcy, the greater risk of developing dSSSI. The dSSSI shows higher serum Hcy level than pSSSI. Elevated serum Hcy is more closely related to dSSSI. In the future, the effectiveness of Hcy-lowering therapy for dSSSI needs to be explored by further clinical studies.

Evaluation of serum homocysteine in young patients presenting with myocardial infarction: a study from rural Maharashtra

Background: It has been shown that elevated serum homocysteine levels are associated with an increased risk of ischemic heart disease (IHD) and stroke. Also, higher homocysteine concentrations in IHD or stroke patients than in controls have been reported. Some prospective and case-control studies with inconsistent results, some with highly significant results and others with no association have been observed. Objective of the study was to evaluate the serum homocysteine level in young myocardial infarction patients of rural hospital.Methods: The present hospital based cross sectional observational study was carried out in Department of Medicine, MIMER Medical College and Hospital, Talegaon Dabhade, Pune. The study population included 45 young patients having acute myocardial Infarction coming to our hospital. The data thus collected was entered in MS excel sheet and analysed by using SPSS 24.0 IBM USA.Results: Mean age of the study cohort was 36.7 years with 48.9% cases in between the age of 31-40 years and 33.3% were in the age range of 41-45 years. Male predominance was seen in the study cases with 68.9% males and 31.1% females. Prevalence of hyperhmocysteinemia was observed as 64.4% in present study. Mortality rate in our study was 6.67%. Serum homocysteine and all lipid parameters were in positive correlation except High-density lipoprotein which has negative correlation. Homocysteine levels were correlating significantly with level of atherosclerosis as measured by Gensini score.Conclusions: Coronary heart disease is related to high serum homocysteine concentration. Serum homocysteine levels also correlates well with the severity of MI.