Homocysteine Levels In Patients Research Articles

Differences in Ca 15-3 and Homocysteine Levels in Patients with Benign Tumor and Breast Cancer

More than 25% of women have complaints related to breast lumps during their lifetime and approximately 12% have breast cancer. Cancer antigen 15-3 and homocysteine can be used as biomarkers in breast cancer. Breast cancer produces pro-inflammatory cytokines that can lead to increased CA 15-3 levels and serum homocysteine levels. Objective: To investigate the differences in CA 15-3 and homocysteine levels between patients with benign tumors and breast cancer. Methods: Observational analytic study with a cross-sectional approach in 30 benign breast tumor patients and 31 breast cancer patients. Measurement of CA 15-3 levels using enzyme linked immunofluorescent assay (ELFA) and homocysteine using competitive enzyme linked immunosorbant assay (ELISA). Comparative tests used independent T test and Mann-Whitney test. The study was conducted in 2023 at Kariadi Hospital Semarang and Ken Saras Hospital Ungaran. Results: CA 15-3 levels in the benign breast tumor group had a median of 11.74 (2.00-40.00) U/mL, while the breast cancer group was 18.66 (7.22-168.97) U/mL (p = 0.001). Homocysteine levels in benign breast tumors had a median of 3.05 (0.10-11.50) µmol/L and in the breast cancer group was 9.90 (3.70-17.20) µmol/L (p = 0.0001). Conclusion: CA 15-3 and homocysteine levels were lower in benign breast tumor patients compared with breast cancer patients.

The Relationship Between Serum Folate and Homocysteine with Head and Neck Cancer: A Systematic Review and Meta-analysis

Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC.

Retracted: Correlation between Collateral Compensation and Homocysteine Levels in Patients with Acute Cerebral Infarction after Intravenous Thrombolysis Based on Medical Big Data

Retracted: Correlation between Collateral Compensation and Homocysteine Levels in Patients with Acute Cerebral Infarction after Intravenous Thrombolysis Based on Medical Big Data

Preliminary Consequences of Blood Pressure Management and Blood Homocysteine Levels with Perindopril in Newly Diagnosed Hypertensive Patients in the Vietnamese Population.

Perindopril is an ACE inhibitor that aids in both blood pressure regulation and homocysteine reduction. Our study aimed to evaluate the results of controlling blood pressure and blood homocysteine levels by perindopril in patients with primary hypertension. A cross-sectional descriptive study with a longitudinal follow-up was conducted on 105 primary hypertensive patients treated with perindopril. The results of our study showed that after 6 weeks of treatment with perindopril, the proportion of patients with the target blood pressure (BP) level accounted for 70.5%, the rate of grade 1 hypertension decreased from 61.0% to 25.7%, grade 2 blood pressure decreased from 17.1% to 3.8%, and there was no case of grade 3 hypertension. At the same time, we also found that the rate of BP control in the group of patients who controlled Hcy below a threshold of 15 μmol/L was significantly higher than in the other group (p < 0.05). Concerning the efficacy of decreasing homocysteine in blood, we discovered that after 6 weeks of treatment with perindopril, the proportion of patients with elevated homocysteine reduced considerably from 74.3% to 40% (p < 0.05). In addition, the homocysteine concentration was 4.33 mol/L lower after treatment than before treatment (95% CI: 3.69-4.97) (p < 0.05). Perindopril helps control blood pressure and reduces blood homocysteine levels in patients with primary hypertension.

Genome-wide analysis of DNA methylation and its relationship with serum homocysteine levels in patients with hypertension.

Homocysteine (Hcy) is an independent risk factor for cardiovascular diseases, and elevated plasma Hcy levels could aggravate vascular injury in hypertension. Hyperhomocysteinemia can change the methylation status of global DNA and specific genes. In the present study, we aim to examine the comprehensive influence of Hcy levels on DNA methylation status in patients with hypertension. Epigenome-wide methylation profiles of the peripheral leukocyte DNA of 218 patients with hypertension were analyzed using the Illumina Infinium Methylation EPIC BeadChip. Differentially methylated positions (DMPs) associated with serum Hcy levels were identified by mixed linear regression with the adjustment of potential confounders. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis were conducted to determine the potential functions of the identified DMPs. The association between the methylation level of DMPs and carotid-femoral pulse wave velocity (Cf-PWV) was also analyzed. Five DMPs at cg13169662, cg03179312, cg21976560, cg25262698, and cg09433843 showed significant association with serum Hcy levels (false discovery rate-corrected P < 0.05). An additional six CpG sites met the threshold for suggestive significance ( P < 1 × 10 -6 ), among which three DMPs (cg25781123, cg26463106, and cg06679221) were annotated to THUMPD3 . Furthermore, the methylation levels of cg13169662 and cg25262698 (RPRD1A) were significantly associated with Cf-PWV. Our results suggest that Hcy could induce DNA methylation alteration in patients with hypertension. Further functional research is warranted to elucidate the concrete role of DMPs in hypertension.

Homocysteine levels in patients with coronary slow flow phenomenon: A meta-analysis.

With the development of coronary angiography, more and more attention has been paid to coronary slow flow phenomenon (CSFP). Recent studies have found that the correlation between homocysteine (Hcy) levels and CSFP was contradictory, so we conducted this meta-analysis to investigate the correlation. By March 2022, studies that meet the research requirements were identified by searching multiple databases including Embase, Web of Science, and PubMed. We included studies evaluating the correlation between Hcy levels and CSFP. Random or fixed effect meta-analyses were performed according to heterogeneity among included studies. A leave-out method and subgroup analyses were conducted to determine the source of heterogeneity. Thirteen studies involving 625 CSFP and 550 subjects were included. After pooling data from each study, Hcy levels were higher in the CSFP groups (standard mean difference [SMD], 1.45; 95% CI, 0.94 to 1.96, P < .00001) than in the control group. In the meta-analysis, there was significant heterogeneity (I2 = 93%), which was further explored through leave-out method and and subgroup analyses. Specifically, pooling data from studies with a mean thrombolysis in myocardial infarction (TIMI) frame count ≥ 46 (SMD, 1.31; 95% CI, 1.00 to 1.63, P < .00001) resulted in no heterogeneity (0%), indicating that the TIMI frame count ≥ 46 was the source of heterogeneity. Our study found that elevated Hcy levels are strongly associated with CSFP. More importantly, the association was stronger in CSFP patients with mean TIMI frame count ≥ 46.

Serum homocysteine level is an independent risk factor for 1-year stroke recurrence in patients with acute ischemic stroke and H-type hypertension: results from the Xi'an stroke registry study of China.

H-type hypertension has a high prevalence in China. However, the association of serum homocysteine levels with 1-year stroke recurrence in patients with acute ischemic stroke (AIS) and H-type hypertension has not been studied. A prospective cohort study of patients with AIS admitted to hospitals between January and December 2015 in Xi'an, China, was conducted. Serum homocysteine levels, demographic data, and other relevant information were collected from all patients upon admission. Stroke recurrences were routinely tracked at 1, 3, 6, and 12 months after discharge. The blood homocysteine level was studied as a continuous variable and tertiles (T1-T3). A multivariable Cox proportional hazard model and a two-piecewise linear regression model were utilized to evaluate the association and ascertain the threshold effect regarding the serum homocysteine level and 1-year stroke recurrence in patients with AIS and H-type hypertension. Overall, 951 patients with AIS and H-type hypertension were enrolled, of whom 61.1% were male. After adjusting for confounders, patients in T3 had a significantly increased risk of recurrent stroke within 1 year, compared with those in T1 as the reference (hazard ratio = 2.24, 95% confidence interval: 1.01-4.97, p = 0.047). Curve fitting showed that serum homocysteine levels were positively curvilinearly correlated with 1-year stroke recurrence. Threshold effect analysis showed that an optimal threshold of serum homocysteine level <25 μmol/L was effective in reducing the risk of 1-year stroke recurrence in patients with AIS and H-type hypertension. Elevated homocysteine levels in patients with severe neurological deficits on admission significantly increased the risk of 1-year stroke recurrence (p for interaction = 0.041). In patients with AIS and H-type hypertension, the serum homocysteine level was an independent risk factor for 1-year stroke recurrence. A serum homocysteine level of ≥25 μmol/L significantly increased the risk of 1-year stroke recurrence. These findings can inform the creation of a more precise homocysteine reference range for the prevention and treatment of 1-year stroke recurrence in patients with AIS and H-type hypertension and provide a theoretical foundation for the individualized prevention and treatment of stroke recurrence.

Plasma lipid profiles and homocysteine levels in anti-N-methyl-D-aspartate receptor encephalitis.

We aimed to investigate whether lipid profiles and homocysteine levels in patients with anti-N-methyl-D-aspartate receptor encephalitis are related to clinical presentation and prognosis, which may contribute to further research on the pathogenesis and treatment of this disease. This study included a total of 43 patients with anti-N-methyl-D-aspartate receptor encephalitis and 43 sex-age-matched healthy controls. Baseline demography, clinical data, patient outcomes, and ancillary examination results were recorded. Patients were followed up every 2-3 months during the first year. The modified Rankin Scale score was used to evaluate the therapeutic effect and clinical outcome. Among the 43 patients included in this study, 55.81% were male, the mean age of onset was 27 years old, and the median modified Rankin Scale score on admission was 3.0. Apolipoprotein A-1 was significantly lower in patients with anti-N-methyl-D-aspartate receptor encephalitis compared with healthy controls (p = 0.004). Compared with healthy controls, homocysteine (p = 0.002), apolipoprotein B (p = 0.004), Lpa (p = 0.045), and apolipoprotein B/apolipoprotein A-1 (p = 0.001) were significantly increased in patients with anti-N-methyl-D-aspartate receptor encephalitis. According to the modified Rankin Scale scores, 6 months after discharge, 72.09% of patients had a good prognosis and 27.91% had a poor prognosis. In the good prognosis group, age (p = 0.031), lipoprotein a (p = 0.023), apolipoprotein A-1 (p = 0.027) at baseline, and the modified Rankin Scale score on admission (p = 0.019) were significantly higher than those in the poor prognosis group. This study suggests the possibility that serum lipid profile and homocysteine play an important role in the pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis, providing support for lipid-lowering treatment of anti-N-methyl-D-aspartate receptor encephalitis patients.

Comparison of salivary and serum homocysteine levels in oral squamous cell carcinoma

Background: No factor alone has been defined as the cause of oral squamous cell carcinoma (SCC). Identification of biochemical markers involved in SCC metabolic reactions is important in SCC diagnosis. Homocysteine is an amino acid whose altered levels have been observed in various malignancies. This study aimed to assess the serum and salivary levels of homocysteine in patients with SCC and compare these data with those of healthy individuals. Methods: In this case-control analytical study, 21 patients with oral SCC and 21 healthy subjects were studied. Salivary and serum samples were obtained, and homocysteine levels were evaluated with an HCY ELISA Kit. Independent t-test and Pearson correlation coefficient were used, and statistical analysis was done using SPSS 17. A P value&lt;0. 05 was considered significant. Results: The level of serum homocysteine was 3.71±2.5 in the patient group and 2.01±2.11 in the control group (P=0.008). The salivary homocysteine levels were 3.12±1.66 in the case group and 2.93±1.71 in control group (P=0.782). Conclusion: Homocysteine levels in the serum might be a good marker for diagnosis of oral SCC; however, more research is needed on using salivary homocysteine levels as a diagnostic indicator.

STUDY THE EFFECT OF BLOOD PRESSURE ON THE LEVEL OF HOMOCYSTEINE IN PATIENTS ADMITTED TO THE TIKRIT TEACHING HOSPITAL

This study sought to the statement of the relationship between blood pressure and ,its impact on the level of homocysteine in the patient's blood plasma, which is a sulfur amino acid is non-essential produced compound medial during the normal process of metabolism amino acid methionine . It took patients samples of blood pressure of patients admitted in the Tikrit Teaching Hospital of (20) satisfactory sample and (10) a sample control and measured its level of homocysteine in the blood plasma, where he showed statistical analysis of the samples by comparing the samples sick with control samples very high rise significantly (P&lt;0.001) the level of homocysteine in patients compared with healthy

STUDY OF PREVALENCE OF HYPERHOMOCYSTEINEMIA IN CHRONIC KIDNEY DISEASEPATIENTS AT TERTIARY CARE HOSPITAL IN NORTHWEST MAHARASHTRA

Introduction-Chronic Kidney Disease is growing problem across all over world and India as well. Chronic kidney disease encompasses a spectrum of different pathophysiological processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate(GFR).The risk for cardiovascular disease (CVD) morbidity and mortality remains high in all stages of CKD, including in patients with hemodialysis. More patients with CKD die of CVD than of the progression of kidney failure.The increase of homocysteine level, referred as hyperhomocysteinemia, is highly prevalent in CKD patients and associated with an increased risk of CVD complications. Proposed mechanisms for hyperhomocysteinemia in kidney failure is due to reduced clearance of total plasma homocysteine (tHcy) secondary to defective kidney and/or extra kidney metabolism of tHcy and deficiencies of folate, vitamin B12, and pyridoxal 5-phosphate (PLP). Aim-To study Serum Homocysteine levels in patients with Chronickidney disease and to estimate Serum Homocysteine levels in different stages of Chronic kidney disease. Materials And Methods- All the patients presenting with clinical, biochemical and ultrasound kidney evidence of chronic kidney disease in department of medicine at tertiary care centre in northern Maharashtra. Normal plasma homocysteine level was considered to bebelow 15 umol/litre. Results- A study of 54 patients with Chronic Kidney disease of both sex were taken as sample. Of the 54 patients 38 were males and 16 were females .36 patients were in age range of 41-60 . 32 patients were in stage 5 CKD , 14 were in stage 4 CKD , 8 were in stage 3 CKD. Hyperhomocysteinemia was observed in 78 % of CKD patients. Serum Homocysteinemia levels were maximum in patients with higher grade of CKD. The associationbetween decreased GFR and increase in serum homocysteine levels was found to be statistically significant. (p&lt;0.05). Conclusion-Study concludes that hyperhomocysteinemia is highly prevalent in CKD patients. Homocysteine is commonly considered as toxicthrombogenic amino acid which causes atherosclerosis and cardiovascular diseases. Mortality due to cardiovascular diseases is high in CKD. Hence early screening and treatment for Hyperhomocysteinemia should be done in CKD to prevent cardiovascular diseases.

The interplay between prolactin and cardiovascular disease.

Hyperprolactinemia can be caused by several conditions and its effects on the hypothalamic-pituitary-gonadal axis are understood in more detail. Nevertheless, in recent decades, other metabolic effects have been studied and data pointed to a potential increased cardiovascular disease (CVD) risk. A recent study showed a decrease in total and LDL- cholesterol only in men with prolactinoma treated with dopamine agonists (DA) supporting the previous results of a population study with increased CVD risk in men harboring prolactinoma. However, other population studies did not find a correlation between prolactin (PRL) levels and CVD risk or mortality. There is also data pointing to an increase in high-density lipoprotein levels, and decreases in triglycerides, carotid-intima-media thickness, C-reactive protein, and homocysteine levels in patients with prolactinoma on DA treatment. PRL was also implicated in endothelial dysfunction in pre and postmenopausal women. Withdrawal of DA resulted in negative changes in vascular parameters and an increase in plasma fibrinogen. It has been shown that PRL levels were positively correlated with blood pressure and inversely correlated with dilatation of the brachial artery and insulin sensitivity, increased homocysteine levels, and elevated D-dimer levels. Regarding possible mechanisms for the association between hyperprolactinemia and CVD risk, they include a possible direct effect of PRL, hypogonadism, and even effects of DA treatment, independently of changes in PRL levels. In conclusion, hyperprolactinemia seems to be associated with impaired endothelial function and DA treatment could improve CVD risk. More studies evaluating CVD risk in hyperprolactinemic patients are important to define a potential indication of treatment beyond hypogonadism.

694 DRUG INDUCED KIDNEY INFARCTION: A CASE REPORT

Abstract Isotretinoin (ISO) is a synthetic analog of vitamin A. Notwithstanding the well-known long-term efficacy in the treatment of severe resistant cystic acne, ISO induces several side effects too. Dyslipidemia, increased liver enzymes, as well as reduction of biotidinase have been already reported [1]. Homocysteine (HCY), a sulfur-containing amino acid, is recycled into methionine by a transmethylation reaction requiring folate and vitamin B12. Given that during ISO treatment elevated liver enzymes (SGOT, SGPT) are often observed, it has been hypothesized that iatrogenic liver dysfunction could affect cystathionine-b-synthase, an enzyme involved in HCY metabolism, [2]. Several studies have highlighted that elevated plasma HCY concentrations are associated with an increased risk of premature occlusive vascular disease. We hereby report a case of drug-induced kidney infarction after ISO therapy. A previously healthy 18-year-old male, on therapy with 40 mg/die isotretinoin for acne, was admitted to the Emergency Unit for abdominal pain, nausea and vomiting and dyspnea. A trans-thoracic echocardiogram showed dilated and hypocontractile left ventricle. During the hospitalization he had a total body CT that showed the presence of an ischemic lesion on left kidney without other pathological findings. He started therapy with 12 IU/kg UFH as soon as a surgical emergency was excluded. Subsequently, he underwent a coronary angiogram that resulted unremarkable. Cardiac MRI showed extensive delayed gadolinium late enhancement with intramural linear pattern. In the hypothesis of drug-induced vasculitis, an extensive serological testing was performed. Elevation of serum liver enzymes (SGOT, SGPT), CRP, LDH was found. Mutations on MTHFR gene and Leiden Factor were not detected, neither alteration in coagulation parameters. Finally the dosage of plasmatic HCY resulted over the range of normality and ISO was discontinued. The patient was discharged on optimized medical therapy for heart failure. He is currently managed as outpatient. HCY levels could be found elevated in patients with ischemic events during ISO treatment. Given the widespread use of this drug for acne, it could be reasonable to dose HCY in patients with suspected liver dysfunction. Physicians should be aware of this scenario and should act swiftly to avoid uneventful outcomes. [1] Schulpis KH et al. Elevated plasma homocysteine levels in patients on isotretinoin therapy for cystic acne. Int J Dermatol. 2001 Jan;40(1):33-6. [2] Polat M, et al. Plasma homocysteine level is elevated in patients on isotretinoin therapy for cystic acne: a prospective controlled study. J Dermatolog Treat. 2008;19(4):229-32.

Relationship of serum homocysteine and vitamin D with positive, negative, and extrapyramidal symptoms in schizophrenia: a case–control study in Iran

BackgroundSchizophrenia is a devastating condition characterized by frequent recurrences, cognitive decline, and emotional and functional disabilities. This condition includes positive and negative symptoms and cognitive impairments resistant to drug treatment. According to studies, many biomarkers can affect this disorder. However, there is little information about vitamin D and homocysteine levels in patients with disease complications. We aimed to investigate this relationship in schizophrenia.MethodIn this case–control study, 33 patients with schizophrenia and 33 healthy individuals were enrolled from Golestan, the north of Iran, in 2021. Blood samples were taken from all participants to assess vitamin D and homocysteine serum levels. In addition, schizophrenic patients completed the Positive And Negative Syndrome Scale (PANSS) and Simpson-Angus Extrapyramidal Side Effects Scale (SAS). Data analysis was performed at a significance level of 0.05 using SPSS 16 software.ResultsOf the 66 participants, 66.7% had vitamin D deficiency, and 71.2% had normal homocysteine levels. However, the serum level of vitamin D was lower in schizophrenic patients than in controls (p = 0.035), and serum homocysteine levels were higher in the schizophrenic group than in controls (p < 0.001). Vitamin D levels in patients with schizophrenia were significantly correlated with the overall assessment of extrapyramidal symptoms (r = 0.35, p = 0.04). However, no significant relationship existed between vitamin D and homocysteine levels and PANSS results (p > 0.05).ConclusionSerum levels of vitamin D and homocysteine were significantly lower and higher in schizophrenic patients than in the control group. Improvement of extrapyramidal symptoms in schizophrenic patients had a direct and significant relationship with serum vitamin D.

Homocysteine Levels in Patients with Hemorragic Stroke: A Cross-sectional Study

Aim: Accumulating data have shown that increased homocysteine (Hcy) is a risk factor for ischemic stroke (IS). However, it remains controversial whether elevated plasma Hcy level is also a risk factor for hemorragic stroke (HS), which accounts for about one-fifth of stroke patients. We aimed to measure the plasma Hcy levels in patients with HS in order to investigate a possible link. &#x0D; Methods: The study included 30 patients with IS, 30 patients with HS, and 30 healthy subjects. Patients were evaluated for conventional risk factors and levels of Hcy, vitamin B12 and folic acid.&#x0D; Results: Hypertension was higher in both IS and HS patients than in healthy participants (p=0.029). Hcy levels were significantly higher in both IS and HS groups than in the control group (p=0.001), with no statistically difference between each other (p&gt;0.05). Vitamin B12 levels were significantly lower in both IS and HS patients than in the controls (p=0.001), with no statistically difference between each other (p&gt;0.05). Folic acid levels did not significantly differ between the three groups (p&gt;0.05). There was no correlation between Hcy, vitamin B12 and folic acid levels (p&gt;0.05).&#x0D; Conclusion: The present study indicated that the Hcy levels were found to be high in the stroke patients regardless of subgroups. As well, there was no correlation between Hcy, vitamin B12 and folate levels in these subgroups. Larger cohorts with better design, will be needed to validate our results.

Dynamics of homocysteine level in patients with osteoporotic fracture

The research was carried out in order to investigate the blood serum level of homocysteine (HCY) which is involved in bone metabolism and has prognostic significance in the monitoring of the regenerative processes in osteoporosis and osteoporotic fractures. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis confirmed by densitometry or X-ray examination­, group II – 15 patients with non-osteoporosis fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. In patients with various fractures osteosynthesis with Ilizarov apparatus or with metal plates was performed. After the operation, the patients were treated in an inpatient setting for a week, then sent for outpatient treatment and prescribed calcium and vitamin D supplements to accelerate the bone regeneration process. A blood sample was taken at 3 stages to monitor the dynamics of HCY level by Elisa test: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times in group I, 5.6 times in group II, and 6.5 times in group III compared to the control group. In the month of recovery, a significant decrease in HCY level was observed in all treated groups but it still remained higher than in the control indicating the need to recommend additional therapeutic prescriptions. Keywords: level of homocysteine, osteoporosis, osteoporotic fractures

Correlation between Collateral Compensation and Homocysteine Levels in Patients with Acute Cerebral Infarction after Intravenous Thrombolysis Based on Medical Big Data.

Homocysteine is an amino acid present in plasma, which is an important intermediate product in the metabolism of methionine and cysteine. Acute cerebral infarction (CI) is called acute CI of stroke. It is one of the most common diseases in neurology and has a serious impact, affecting people's lives. This article is aimed at studying the effect of data mining algorithms based on medical big data and the improved apriori algorithm on the analysis of the correlation between collateral compensation and homocysteine levels in patients with acute CI. This article proposes that there are many factors in patients with acute CI, among which are collateral compensation and homocysteine levels that are not easily determined. From the data in the tables in the experiment of this article, it can be seen that the collateral circulation of patients with acute CI is 8%, and the collateral circulation of patients without acute CI is 35%. The results indicate that both collateral compensation and homocysteine levels affect patients with acute CI. The higher the homocysteine level, the greater the probability of acute CI, and the better the state of collateral circulation, the less likely it is to suffer from acute CI.

The effects of vitamin B12 supplementation on metabolic profile of patients with non-alcoholic fatty liver disease: a randomized controlled trial

The present study is the first effort to evaluate the effects of vitamin B12 supplementation on the serum level of liver enzymes, homocysteine, grade of hepatic steatosis, and metabolic profiles in patients with non-alcoholic fatty liver disease (NAFLD). Forty patients with NAFLD were enrolled in a double-blind placebo-controlled trial to receive either one oral tablet of vitamin B12 (1000 µg cyanocobalamin) or a placebo per day for 12 weeks. We investigated serum levels of homocysteine, aminotransferases, fasting blood glucose (FBG), lipids, malondialdehyde (MDA), and homeostasis model assessment of insulin resistance (HOMA-IR). The grade of liver steatosis and fibrosis was measured by real-time 2-dimensional shear wave elastography. Vitamin B12 supplementation significantly decreased serum levels of homocysteine compared to placebo (medians: − 2.1 vs. − 0.003 µmol/l; P = 0.038). Although serum alanine transaminase (ALT) in the vitamin B12 group decreased significantly, this change did not reach a significant level compared to the placebo group (medians: − 7.0 vs. 0.0 IU/l; P > 0.05). Despite the significant within-group decrease in FBG, MDA, and liver steatosis in the vitamin B12 group, between-group comparisons did not reveal any significant difference. Vitamin B12 supplementation might decrease serum levels of homocysteine in patients with NAFLD. The fasting blood glucose and serum levels of MDA were significantly improved in the trial group who received vitamin B12. However, these changes did not reach a significant level compared to the placebo group. In this respect, further studies with larger sample sizes, different doses, and types of vitamin B12 will reveal additional evidence.Trial Registration: At http://irct.ir/ as IRCT20120718010333N5 on December 25, 2019.

VITAMIN B 12 AND HOMOCYSTEINE LEVELS IN PRIMI GRAVIDA PATIENTS WITH PRE-ECLAMPSIA: AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL OF PAKISTAN

Objective: To determine the frequency of serum vitamin B12 and homocysteine levels in patients with Pre-ec­lampsia. Methodology: This cross-sectional study was carried out in Department of Gynecology and Obstetrics, Lady Read­ing Hospital, Peshawar in collaboration with the Department of Biochemistry of Khyber Medical University (KMU), from May 2019 to December 2019 after obtaining ethical approval from Advanced Study and Research Board (ASRB). Using non-probability convenient sample technique, 60 patients who were Primi Gravida with Pre-eclamp­sia were admitted via OPD or labour room. Data was collected from hospital record , charts and documented and analyzed in SPSS version 22. Results: The mean age of the patients in this study was 21.75 ± 2.05 years. The mean vitamin B 12 levels recorded in our study was 175 ± 34.39 pmol/l. Vitamin B 12 levels in most of the participants, 45(75%) were in normal ranges. 12(20%) patients were deficient in vitamin B 12 levels while 03(05%) patients had high levels of vitamin B12. The mean serum Homocysteine level in our study was 9.63 ± 3.46 umol/l. Most of the participants 48 (80%) had normal levels while 09(15%) patients had high levels of serum Homocysteine while only 03 (05%) patients were deficient in serum Homocysteine levels. Conclusion: Majority of the patients with Pre eclampsia had normal levels of Homocysteine and vitamin B12. There was an inverse correlation between serum Vitamin B12 and Homocysteine levels in Pre-eclamptic patients

Serum Homocysteine Level in Patients of Type 2 Diabetes Mellitus with Macrovascular Complications

The risk of CVD in men with DM is 3-fold and in women with DM 5-fold in comparison to those without diabetes(1). Diabetes is a recognized independent risk factor for stroke and is associated with higher morbidity and mortality(2-4). The severity and duration of DM are important predictors of both the incidence and the extent of PAD, as observed in United Kingdom Prospective Diabetes Study, where each 1% increase in glycosylated hemoglobin was correlated with a 28% increase in incidence of PAD, and higher rates of death, microvascular complications and major amputation.(5,6) Homocysteine concentration is found to be higher in patients with peripheral vascular, cerebrovascular and coronary artery diseases than those without such diseases.(7) This observational comparative study was done at Ramakrishna Care Hospital, Raipur, from January 2017 to June 2018 involving 100 type 2 diabetes mellitus patients. Patients were divided into two groups- Group 1: The Case Group- Type 2 DM patients with macrovascular complications. Group 2: The Control Group - Type 2 DM patients without any macrovascular complications With the help of Clinical evaluation and detailed investigations we had determined the presence of macrovascular complications in which we had included Myocardial infarction, CVA and Peripheral vascular disease. Data obtained from these patients were analysed and the results were compared with prior studies of similar objectives. Higher age and duration of diabetes thus had a positive correlation with macrovascular disease. The mean serum homocysteine level was statistically significant and they correlate with higher incidence of macrovascular disease in males and with increasing age. Keywords: Type 2 Diabetes Mellitus, DM, CVD, CVA, Serum Homocysteine Level, Macrovascular Complications.