Homocysteine Levels Research Articles

The role of some indicators of the antioxidant system and adipose tissue metabolism in predicting isthmic-cervical insufficiency

Objective: to evaluate the role of some indicators of antioxidant system and adipose tissue metabolism in predicting preterm birth in pregnant women with isthmic-cervical insufficiency.Materials and methods: the study included 117 pregnant women divided in two clinical groups: group I — 57 pregnant women with isthmic-cervical insufficiency, who underwent surgical cerclage, group II — 60 women with a physiological pregnancy. Using enzyme immunoassay, we determined the levels of superoxide dismutase, catalase, ceruloplasmin, leptin, homocysteine, ghrelin, resistin and adiponectin in the blood serum of pregnant women of clinical groups.Results: it has been established that catalase has the greatest prognostic significance in relation to isthmic-cervical insufficiency on the part of the antioxidant system, and leptin, resistin and homocysteine on the part of adipose tissue metabolism indicators.Conclusions: determination of the level of some isthmic-cervical insufficiency associated indicators of oxidative stress and lipid metabolism in the first trimester of pregnancy can be successfully used to form a risk group, early prediction and timely prevention of isthmic-cervical insufficiency.

The Difference in Serum Metabolomic Profiles between the Good and Poor Outcome Groups at 3 Months in the Early and Late Phases of Aneurysmal Subarachnoid Hemorrhage.

We aimed to investigate the characteristics of serum metabolomics in aneurysmal subarachnoid hemorrhage patients (aSAH) with different 3-month outcomes (good = modified Rankin score: 0-3 vs. poor = mRS 4-6). We collected serum samples from 46 aSAH patients at 24 (D1) and 168 (D7) hours after injury for analysis by liquid chromatography-mass spectrometry. Ninety-six different metabolites were identified. Groups were compared using multivariate (orthogonal partial least squares discriminant analysis), univariate, and receiving operator characteristic (ROC) methods. We observed a marked decrease in serum homocysteine levels at the late phase (D7) compared to the early phase (D1). At both D1 and D7, mannose and sorbose levels were notably higher, alongside elevated levels of kynurenine (D1) and increased 2-hydroxybutyrate, methyl-galactoside, creatine, xanthosine, p-hydroxyphenylacetate, N-acetylalanine, and N-acetylmethionine (all D7) in the poor outcome group. Conversely, levels of guanidinoacetate (D7) and several amino acids (both D1 and D7) were significantly lower in patients with poor outcomes. Our results indicate significant changes in energy metabolism, shifting towards ketosis and alternative energy sources, both in the early and late phases, even with adequate enteral nutrition, particularly in patients with poor outcomes. The early activation of the kynurenine pathway may also play a role in this process.

The effect of 12weeks of aerobic exercise training with or without saffron supplementation on diabetes-specific markers and inflammation in women with type 2 diabetes: A randomized double-blind placebo-controlled trial.

This study was conducted to investigate the effects of 12weeks of aerobic exercise (AT) and saffron supplementation on hemostasis, inflammatory markers, and insulin resistance in obese women diagnosed with type 2 diabetes (T2D). A total of 44 women with T2D (mean age: 54.12±5.63years, mean BMI: 31.15±1.50kg/m2, HbA1c: 85±4.2mmol/mol) were included in a randomized, double-blind, placebo-controlled study. We were randomly assigned to one of four groups (n=11 per group): saffron+training (ST), placebo+training (PT), saffron supplement (SS), and placebo (P). The ST and PT groups completed 12weeks of AT (three sessions per week of mild to moderate intensity). The ST and SS groups were administered a daily dose of 200mg of saffron powder for 12weeks. Fasting blood samples were collected 48h before the first AT session and/or nutritional supplementation and 48h after the last AT session and/or nutritional supplementation. Post-evaluation, homeostatic model assessment of insulin resistance value (HOMA-IR, p<0.001) and serum levels of glucose (p<0.001), fibrinogen (FIB, p<0.001), homocysteine (HCY, p<0.001), interleukin-6 (IL-6, p<0.001), and tumor necrosis factor α (TNFα, p<0.001) showed significant reduction in the ST, PT, and SS groups compared to the P group (p<0.05). In particular, the ST group showed a more significant reduction in all variables compared to the PT and SS groups (p<0.05). Our results suggest that a 12-week intervention with AT and saffron supplementation can independently improve markers related to hemostasis, inflammation, and insulin resistance. However, their combination showed the greatest effectiveness on the above markers.

Role of Folate in Liver Diseases.

Folate is a water-soluble B vitamin involved in the synthesis of purines and pyrimidines and is one of the essential vitamins for human growth and reproduction. Folate deficiency due to low dietary intake, poor absorption of folate, and alterations in folate metabolism due to genetic defects or drug interactions significantly increases the risk of diseases such as neural tube defects, cardiovascular disease, cancer, and cognitive dysfunction. Recent studies have shown that folate deficiency can cause hyperhomocysteinemia, which increases the risk of hypertension and cardiovascular disease, and that high homocysteine levels are an independent risk factor for liver fibrosis and cirrhosis. In addition, folate deficiency results in increased secretion of pro-inflammatory factors and impaired lipid metabolism in the liver, leading to lipid accumulation in hepatocytes and fibrosis. There is substantial evidence that folate deficiency contributes to the development and progression of a variety of liver diseases, including non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), alcoholic liver disease (ALD), viral hepatitis, hepatic fibrosis, and liver cancer. Here we review key studies on the role of folate in the pathophysiology of liver diseases, summarize the current status of studies on folate in the treatment of liver diseases, and speculate that folate may be a potential therapeutic target for liver diseases.

Investigating the Prevalence of Protein S, Protein C, Factor V Leiden, and Homocysteine Disorders in Patients with Antiphospholipid Syndrome: A Retrospective Study

Background: Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease primarily characterized by thrombosis. Previous studies have indicated that disorders in proteins S and C, Factor V Leiden, and homocysteine levels can contribute to the occurrence of miscarriage in patients with APS. Objectives: This study aims to determine the prevalence of protein S, protein C, Factor V Leiden, and homocysteine disorders in patients with APS. Methods: This research was conducted as a retrospective study, utilizing the clinical information of patients who were referred to Golestan Ahvaz Hospital and whose records were available. A pre-prepared checklist was used to extract and record patients' clinical information, including demographic data, prevalence of miscarriage, vascular disorders (arterial and venous), pulmonary and venous thrombosis, preterm labor, intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), and disorders or deficiencies of proteins C and S, as well as homocysteine levels. Results: In the present study, the results showed that a reduction in proteins C and S was observed in 18 (15.1%) and 20 (16.8%) patients, respectively. Thrombosis was present in 103 (86.6%) patients, and 27 (22.7%) patients had Aps Ab. The results indicated a statistically significant relationship between protein C deficiency, thrombosis, vascular events, and the presence of Abs in patients (P &lt; 0.05) Additionally, a significant relationship was found between protein C deficiency and IUFD (P &lt; 0.05). However, no significant relationship was observed between Aps Ab and IUFD or IUGR (P &gt; 0.05). Conclusions: The results indicated that protein C can be used as a diagnostic factor in AP patients. Additionally, protein C was associated with IUFD in these patients.

Predicting ineffective thrombolysis in acute ischemic stroke with clinical and biochemical markers

**Ischemic stroke remains a leading cause of morbidity and mortality globally. Despite the advances in thrombolytic therapy, notably recombinant tissue plasminogen activator (rtPA), patient outcomes are highly variable. This study aims to introduce a novel predictive model, the Acute Stroke Thrombolysis Non-Responder Prediction Model (ASTN-RPM), to identify patients unlikely to benefit from rtPA within the critical early recovery window. We conducted a retrospective cohort study at Baoding No.1 Central Hospital including 709 adult patients diagnosed with acute ischemic stroke and treated with intravenous alteplase within the therapeutic time window. The ASTN-RPM was developed using Least Absolute Shrinkage and Selection Operator (LASSO) regression technique, incorporating a wide range of biomarkers and clinical parameters. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, calibration plots, and Decision Curve Analysis (DCA). ASTN-RPM effectively identified patients at high risk of poor response to thrombolysis, with an AUC of 0.909 in the training set and 0.872 in the validation set, indicating high sensitivity and specificity. Key predictors included posterior circulation stroke, high admission NIHSS scores, extended door to needle time, and certain laboratory parameters like homocysteine levels. The ASTN-RPM stands as a potential tool for refining clinical decision-making in ischemic stroke management. By anticipating thrombolytic non-response, clinicians can personalize treatment strategies, possibly improving patient outcomes and reducing the burden of ineffective interventions. Future studies are needed for external validation and to explore the incorporation of emerging biomarkers and imaging data.

Association between Cerebral Small Vessel Disease and Plasma Levels of LDL Cholesterol and Homocysteine: Implications for Cognitive Function

Background: Investigate the correlation between low-density lipoprotein (LDL) cholesterol, homocysteine and cognitive function in patients with cerebral small vessel disease (CSVD). Methods: 240 patients with CSVD confirmed by head MRI in the Department of Neurology from January 2020 to December 2023 were retrospectively included in the study. All the patients had complete blood biochemical examination, and their cognitive function was evaluated by Montreal Cognitive Assessment Scale (MoCA), and after correcting for the factor of years of education, the patients were divided into a group of normal cognition (MoCA ≥26, 70 patients) and a group of cognitive function (MoCA ≥26, 70 patients) according to the scores. After correcting for the factor of years of education, the patients were divided into the normal cognitive function group (70 cases with MoCA ≥26) and the cognitive dysfunction group (170 cases with MoCA &lt;26) according to their scores. The general information of the two groups and the patients' cognitive function characteristics, including visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation, were compared, and the independent influences on the occurrence of cognitive dysfunction in patients with CSVD were analyzed by two-category multifactorial logistic regression. Results: Compared with the group with normal cognitive function, the cognitive dysfunction group had lower years of education and higher homocysteine, and the differences were statistically significant (P &lt; 0.05). Compared with the group with normal cognitive functioning, the cognitive dysfunction group had lower MoCA total scores, lower visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation scores, and the differences were statistically significant (P &lt; 0.05). Two-category multifactorial logistic regression analysis showed that low-density lipoprotein cholesterol (OR=2.756, 95% CI:0.673-0.938, P=0.012) and homocysteine (OR=1.859, 95% CI: 1.024-1.324, P=0.016) were the independent factors influencing cognitive dysfunction in CSVD patients. The lower the risk of cognitive impairment in CSVD patients, the higher the plasma LDL cholesterol and homocysteine levels, the higher the risk of cognitive impairment in CSVD patients. Conclusion: Plasma LDL cholesterol and homocysteine levels are associated with and may be predictors of cognitive dysfunction in patients with CSVD.

Amentoflavone attenuates homocysteine-induced neuronal ferroptosis-mediated inflammatory response: Involvement of the SLC7A11/GPX4 axis activation

Elevated homocysteine (Hcy) levels, referred to hyperhomocysteinemia, are associated with an increased risk of several neurological disorders. Ferroptosis and inflammation play a vital role in Hcy-induced neuronal dysfunction. Amentoflavone (AMF), an active natural biflavone compound, exhibits antioxidative, anti-inflammatory, and neuroprotective activities. This study aimed to explore the potential effects of AMF on Hcy-induced neuronal injury, with a particular focus on the underlying mechanisms involving ferroptosis and inflammation. We assessed neuronal damage in HT22 cells by measuring cell viability, lactate dehydrogenase (LDH) release, and proliferation rates. Additionally, we evaluated oxidative stress markers including the levels of reactive oxygen species (ROS), MitoSOX, mitochondrial membrane potential (MMP), malondialdehyde (MDA), and glutathione (GSH). Iron metabolism and ferroptosis-related gene expressions (Ptgs2, Tfr1, and Fth1) were quantified. TheSLC7A11/GPX4 axis was also detected. Our results showed that AMF treatment dramatically mitigated Hcy-induced neuronal injury by increasing cell viability, decreasing LDH release, and promoting cell proliferation. AMF treatment also reduced Hcy-induced oxidative stress and lipid peroxidation, as evidenced by reduced ROS, MitoSOX, MMP, and MDA levels, along with an increased GSH content in HT22 cells. In addition, AMF treatment reduced iron content and ferroptosis-related gene mRNA levels. However, Erastin, a ferroptosis inducer, blocked these neuroprotective effects of AMF. Ferroptosis inhibitor Ferrostatin-1 also attenuated Hcy-induced ferroptosis. Moreover, both AMF and Ferrostatin-1 effectively mitigated Hcy-induced inflammation, which was again antagonized by Erastin. Mechanistically, AMF treatment enhanced SLC7A11/GPX4 axis in Hcy-treated HT22 cells. In conclusion, these findings suggest that AMF possesses neuroprotection against Hcy-induced injury primarily by inhibiting ferroptosis-mediated inflammation, partly through the activation of SLC7A11/GPX4 axis.

Ciliary neurotrophic factor promotes the development of homocysteine-induced vascular endothelial injury through inflammation mediated by the JAK2/STAT3 signaling pathway

Elevated homocysteine (Hcy) levels have been recognized as significant risk factor for cardiovascular and cerebrovascular diseases, closely related to endothelial injury. While expression of Ciliary Neurotrophic Factor (CNTF) significantly increases during Hcy-induced vascular endothelial cell injury, the precise molecular pathways through which CNTF operates remain to be clarified. To induce vascular endothelial cell injury, human umbilical vein endothelial cells (HUVECs) were treated with Hcy. Cell viability and apoptosis in HUVECs were assessed using the CCK-8 assay and flow cytometry. Western blot analysis determined the expression levels of the JAK2-STAT3 pathway, inflammation-related factors (IL-1β, NLRP3, ICAM-1, VCAM-1), and apoptosis-related factors (cleaved Caspase-3 and Bax). Immunofluorescence staining and western blotting were employed to examine CD31 and α-SMA expression. Knockdown of CNTF was achieved using lentiviral interference, and its effects on inflammation and cell injury were evaluated. Chromatin immunoprecipitation (ChIP) and dual luciferase reporter analysis were conducted to investigate the interaction between the MAFK and CNTF promoters. Our results indicated that Hcy induced high expression of CNTF and activated the JAK2-STAT3 signaling pathway, thereby upregulating factors associated with inflammation and cell apoptosis. Inhibiting CNTF alleviated Hcy-induced inflammation and cell injury. MAFK was identified as a transcription factor promoting CNTF transcription, and its overexpression exacerbated inflammation and cell injury in Hcy-treated HUVECs through the CNTF-JAK2-STAT3 axis, which could be reversed by knocking down CNTF. Activation of MAFK leads to CNTF upregulation, which activates the JAK2-STAT3 signaling pathway, regulating inflammation and inducing injury in Hcy-exposed vascular endothelial cells. Targeting CNTF or its upstream regulator MAFK may represent potential therapeutic strategies for mitigating endothelial dysfunction associated with hyperhomocysteinemia and cardiovascular diseases.

Evaluation of serum folic acid level in patients with type 2 diabetes mellitus

Background and objectives: Type-2 diabetes mellitus is a metabolic disorder. Diabetic patients with low folic acid, high homocysteine levels, have a higher chance of developing coronary heart disease based on previous studies. Therefore, this study aimed to investigate the serum levels of folic acid and homocysteine in type-2 diabetes mellitus patients and their association with insulin resistance. Methods: This cross-sectional study has been conducted on 138 participants from February 2nd 2022 to August 3rd 2022, at Azadi teaching hospital/clinical biochemistry department- Duhok, Kurdistan region, Iraq. The participants were composed of two groups, 70 patients with type-2 diabetes mellitus, and 68 apparently healthy control. Both groups have been investigated for serum folic acid level, serum glucose, serum insulin, serum homocysteine, glycosylated hemoglobin, and Homeostatic Model Assessment for Insulin Resistance. Results: The mean age for type 2 diabetic patients was (51.24 years) with males predominant (64.29%). Type 2 diabetic patients showed a low level of mean serum folic acid concentrations (2.73 ng/ml) in comparison with healthy subjects (5.91 ng/ml) (p&lt;0.001), and the mean serum homocysteine concentration was (13.493 ?mol/L) among type 2 diabetic patients compared to healthy subjects (10.041 ?mol/L) (p&lt;0.001). Significant correlation was found between serum folic acid and serum homocysteine levels, and glycosylated hemoglobin (p&lt;0.05 and p&lt;0.001, respectively). Conclusion: Patients with type-2 diabetes mellitus were associated with low mean serum folic acid levels and high mean serum homocysteine levels.

Effects of Blood Flow Restriction Resistance Training on Autonomic and Endothelial Function in Persons with Parkinson's Disease.

Autonomic dysfunction precedes endothelial dysfunction in Parkinson's disease (PD) and causes blood pressure and circulation abnormalities that are highly disruptive to one's quality of life. While exercise interventions have proven helpful for motor symptoms of PD, improving associated non-motor symptoms is limited. Low-intensity resistance training with blood flow restriction (LIRT-BFR) improves autonomic dysfunction in non-PD patients and high-intensity resistance training (HIRT) is recommended for motor symptom improvements for people with PD (PwPD). To determine the effects of LIRT-BFR and HIRT on homocysteine and autonomic and endothelial function in PwPD and to determine the hemodynamic loads during LIRT-BFR and HIRT in PwPD using a novel exercise protocol. Thirty-eight PwPD were assigned LIRT-BFR, HIRT or to a control (CNTRL) group. The LIRT-BFR and HIRT groups exercised three days per week for four weeks. The LIRT-BFR protocol used 60% limb occlusion pressure (LOP) and performed three sets of 20 repetitions at 20% of the one-repetition maximum (1RM). The HIRT group performed three sets of eight repetitions at 80% 1RM. The CNTRL group was asked to continue their normal daily routines. LIRT-BFR significantly improved orthostatic hypotension (p = 0.026), homocysteine levels (p < 0.001), peripheral circulation (p = 0.003), supine blood pressure (p = 0.028) and heart rate variability (p = 0.041); LIRT-BFR improved homocysteine levels (p < 0.018), peripheral circulation (p = 0.005), supine blood pressure (p = 0.007) and heart rate variability (p = 0.047) more than HIRT; and hemodynamic loads for LIRT-BFR and HIRT were similar. LIRT-BFR may be more effective than HIRT for autonomic and endothelial function improvements in PwPD and hemodynamic loads may be lessened in LIRT-BFR protocols using single-joint exercises with intermittent blood flow restriction. Further research is needed to determine if non-motor symptoms improve over time and if results are sustainable.

Relationships between minerals’ intake and blood homocysteine levels based on three machine learning methods: a large cross-sectional study

BackgroundBlood homocysteine (Hcy) level has become a sensitive indicator in predicting the development of cardiovascular disease. Studies have shown an association between individual mineral intake and blood Hcy levels. The effect of mixed minerals’ intake on blood Hcy levels is unknown.MethodsData were obtained from the baseline survey data of the Shanghai Suburban Adult Cohort and Biobank(SSACB) in 2016. A total of 38273 participants aged 20–74 years met our inclusion and exclusion criteria. Food frequency questionnaire (FFQ) was used to calculate the intake of 10 minerals (calcium, potassium, magnesium, sodium, iron, zinc, selenium, phosphorus, copper and manganese). Measuring the concentration of Hcy in the morning fasting blood sample. Traditional regression models were used to assess the relationship between individual minerals’ intake and blood Hcy levels. Three machine learning models (WQS, Qg-comp, and BKMR) were used to the relationship between mixed minerals’ intake and blood Hcy levels, distinguishing the individual effects of each mineral and determining their respective weights in the joint effect.ResultsTraditional regression model showed that higher intake of calcium, phosphorus, potassium, magnesium, iron, zinc, copper, and manganese was associated with lower blood Hcy levels. Both Qg-comp and BKMR results consistently indicate that higher intake of mixed minerals is associated with lower blood Hcy levels. Calcium exhibits the highest weight in the joint effect in the WQS model. In Qg-comp, iron has the highest positive weight, while manganese has the highest negative weight. The BKMR results of the subsample after 10,000 iterations showed that except for sodium, all nine minerals had the high weights in the joint effect on the effect of blood Hcy levels.ConclusionOverall, higher mixed mineral’s intake was associated with lower blood Hcy levels, and each mineral contributed differently to the joint effect. Future studies are available to further explore the mechanisms underlying this association, and the potential impact of mixed minerals’ intake on other health indicators needs to be further investigated. These efforts will help provide additional insights to deepen our understanding of mixed minerals and their potential role in health maintenance.

Homocysteine concentration in coronary artery disease and severity of coronary lesions.

Our previous study reckons that the impact of the rs1801133 variant of 5,10-methylenetetrahydrofolate reductase (MTHFR) on coronary artery disease (CAD) is possibly mediated by cardiometabolic disorder. This study is performed to verify this hypothesis. Four hundred and thirty CAD patients and 216 CAD-free individuals were enrolled in this case-control study. The rs1801133 variant was genotyped by PCR-RFLP. Severity of coronary lesions was evaluated by number of stenotic coronary vessels and extent of coronary stenosis. The rs1801133 T allele significantly increased homocysteine levels in patients with CAD and CAD-free individuals. Individuals with the T allele of rs1801133 had an increased risk of developing CAD. In contrast, individuals with the TT genotype of rs1801133 were at high risk of multiple vessel lesions. The carriers of CT genotype had higher levels of systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein (hs-CRP), and lower levels of apolipoprotein A1 (APOA1) than those with CC genotype in male patients with CAD. The receiver operating characteristic (ROC) curve and precision-recall (PR) curve indicated that hyperhomocysteinemia was sensitive to predict the severity of CAD. Multivariate logistic regression revealed that homocysteine, rs1801133, age, smoking, weight, body mass index (BMI), lipoprotein(a) [Lp(a)], and hs-CRP were independent risk factors for CAD. The increased risk of CAD and severity of coronary lesions associated with rs1801133 in the Chinese Han population were attributed, at least partly, to high homocysteine levels. Hyperhomocysteinemia had a high predictive value for severe CAD or multiple vessel lesions.

Vitamin B12 Deficiency-Induced Neuropathy and Cognitive and Motor Impairment in the Elderly: A Case Study.

Vitamin B12 deficiency can present with a variety of neurological and cognitive symptoms. Especially in elderly patients, vitamin B12 deficiency can be easily overlooked because symptoms may be attributed to comorbid conditions or solely to the aging process. In this case study, we present two patients, a 71-year-old man and a 74-year-old female, with vitamin B12 deficiency. The male patient had a history of (partial) resection of the ileum/jejunum/colon because of intestinal ischemia. The female patient had a history of hypothyroidism, type 2 diabetes with complications (including peripheral neuropathy), mitochondrial myopathy, and chronic lymphocytic leukemia. Both patients presented with severe fatigue, cognitive impairment, and impaired walking. Next to this, the male patient suffered from depressive symptoms and mild disorientation, and the female patient experienced neuropathic pain. She also mentioned a positive family history for B12 deficiency. The first patient had normal to high B12 levels because he was already on B12 injections (once every three weeks) because of an earlier diagnosed B12 deficiency. The female patient had B12 levels within normal range (holotranscobalamin 54 pmol/L) and her diagnosis was confirmed by elevated homocysteine and methylmalonic acid levels. Treatment with frequent hydroxocobalamin injections and other supplements significantly improved their cognitive, emotional, and motor functions. These cases underscore the need for a high level of clinical suspicion in elderly patients, also in cases of normal B12 levels but with clinical signs of deficiency and a positive risk factor, such as stomach or small bowel surgery or positive family history.

Cognitive Function and Medication Adherence in Older Adults With H-Type Hypertension: The Mediating Effect of Metamemory.

Medication adherence in adults with H-type hypertension plays a crucial role in lowering blood pressure and treating complications. Cognitive function has been identified as a significant influencing factor for medication adherence, whereas excessive levels of homocysteine can impair cognitive function. Metamemory, which is influenced by cognitive function, also affects medication adherence. However, the complex relationship among these factors remains poorly understood among adults with H-type hypertension. Therefore, we hypothesize that metamemory serves as a mediator for the impact of cognitive function on medication adherence. A total of 232 adults with H-type hypertension were enrolled to provide cognitive function scores, metamemory scores, and medication adherence rates. A pairwise correlation exists among cognitive function, metamemory, and medication adherence. Metamemory partially mediates (57.5%) the relationship between cognitive function and medication adherence. Our findings suggest that interventions targeting improvements in metamemory may enhance medication adherence among individuals with H-type hypertension. [Journal of Gerontological Nursing, 50(6), 44-52.].

Docosahexaenoic acid, eicosapentaenoic acid, arachidonic acid, and neural tube defects in Tunisian population.

To determine the effect of maternal status in (plasma and red blood cell) folate, vitamin B12, homocysteine, and vitamin D, as well as their interaction with MTHFR (C677T and A1298C) and MTRR A66G polymorphisms, on maternal plasma docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA) levels and the risk of neural tube defects (NTDs). ARA, EPA, and DHA composition was assessed using capillary gas chromatography. ARA and DHA levels were higher in controls than in case mothers for low plasma folate status. For low red blood cell folate status, DHA levels were higher in controls than in case mothers. For high homocysteine levels, ARA and DHA levels were higher in controls than in case mothers. NTD mothers had lower EPA and DHA levels for low vitamin B12 levels. NTD mothers had lower DHA levels for low vitamin D levels. For low plasma folate status, DHA levels in the MTHFR C677T gene and ARA and EPA levels in MTHFR A1298C gene were different among the three genotypes in case mothers. DHA levels in the MTHFR C677T gene were different among the three genotypes in case mothers for both low and high homocysteine levels. For low vitamin B12 levels, ARA and DHA levels were different among the three genotypes of the MTHFR C677T gene in case mothers. In the MTHFR C677T gene, ARA and DHA levels were different among the three genotypes in case mothers for low vitamin D levels. More advanced research is required to verify a suitable biochemical parameter status in relation to the genotypes in pregnant women.

Risk factors for thrombosis in dialysis patients: A comprehensive systematic review and meta-analysis

AimTo identify the factors associated with thrombosis in dialysis patients. BackgroundThrombosis is a leading cause of vascular access failure in dialysis patients. Numerous risk factors contribute to thrombosis in this population. MethodsA systematic search was conducted across international databases using standardized keywords. The quality of the selected studies was assessed using the STROBE and CONSORT checklists. The findings were summarized in a Garrard table. Meta-analysis was performed using CMA software. The study adhered to the guidelines outlined in the PRISMA statement. ResultsA total of 180 articles were reviewed. The odds ratio for thrombosis in patients with arteriovenous grafts compared to arteriovenous fistulas was 10.93 (95 % CI: 9.35-12.78), demonstrating statistical significance (P = 0.001). Similarly, hemodialysis patients had an odds ratio of thrombosis 3.60 times higher than non-hemodialysis patients (95 % CI: 3.54-4.19), with statistical significance (P = 0.001). Patients undergoing single-stage basilic vein transposition had a 1.89 times higher risk of thrombosis compared to those undergoing two-stage transposition (95 % CI: 1.04-3.46), also demonstrating statistical significance (P = 0.038). ConclusionsThrombosis in patients with end-stage renal disease undergoing dialysis was significantly associated with various factors, including graft access, single-stage basilic vein transposition, and hemodialysis. Additional contributing factors to thrombosis included diabetes, elevated homocysteine levels, female gender, age over 50, access location, and low access blood flow velocity. The analysis revealed a higher incidence of thrombosis in end-stage renal disease patients undergoing hemodialysis compared to those not undergoing dialysis, as well as in patients with arteriovenous grafts compared to those with arteriovenous fistulas. These findings underscore the importance of recognizing and managing these risk factors to prevent thrombotic events and enhance patient care within the dialysis setting.

The different roles of homocysteine metabolism in hypertension among normal-weight and obese patients with obstructive sleep apnea

BackgroundObstructive sleep apnea (OSA) is associated with hypertension. However, the differential mechanisms underlying OSA-related hypertension between normal-weight vs. obese patients is limited. MethodsWe studied 92 patients with OSA and 24 patients with continuous positive airway pressure (CPAP) treatment. Blood pressure (BP) was measured twice during awake and continuously monitored during sleep. Obesity was defined as body mass index ≥28 kg/m2. Serum metabolite levels were assessed by metabolomics. ResultsAmong 59 normal-weight and 33 obese patients, 651 and 167 metabolites showed differences between hypertension and normotension or were associated with systolic and diastolic BP (SBP, DBP) after controlling confounders. These metabolites involved 16 and 12 Kyoto Encyclopedia of Genes and Genomes enrichment pathways in normal-weight and obese patients respectively, whereas 6 pathways overlapped. Among these 6 overlapping pathways, 4 were related to homocysteine metabolism and 2 were non-specific pathways. In homocysteine metabolism pathway, 13 metabolites were identified. Interestingly, the change trends of 7 metabolites associated with SBP (all interaction-p≤0.083) and 8 metabolites associated with DBP (all interaction-p≤0.033) were opposite between normal-weight and obese patients. Specifically, increased BP was associated with down-regulated folate-dependent remethylation and accelerated transsulfuration in normal-weight patients, whereas associated with enhanced betaine-dependent remethylation and reduced transsulfuration in obese patients. Similar findings were observed in ambulatory BP during sleep. After CPAP treatment, baseline low homocysteine levels predicted greater decrease in DBP among normal-weight but not obese patients. ConclusionsMechanisms in OSA-related hypertension differ between normal-weight and obese patients, which are explained by different changes in homocysteine metabolism.

Is serum homocysteine level a biomarker of suicide attempts: A preliminary study

Suicide is a global public health concern, and understanding its multifaceted determinants is crucial for effective prevention. This study was designed to find an answer to the question of whether serum homocysteine level can be a biomarker of suicide attempts. This preliminary study involving 90 participants (45 suicide attempt cases and 45 controls) was conducted at Elazig Fethi Sekin City Hospital. Biochemical analyses were performed to assess serum homocysteine, vitamin B12, and folic acid levels. Statistical analyses, including t-tests, Mann-Whitney U tests, and ROC analysis, were employed to explore differences between groups and assess the diagnostic potential of homocysteine. Elevated homocysteine levels were found in individuals who attempted suicide compared to the control group (p= <0.001). Additionally, lower levels of vitamin B12 (p=<0.001) and folic acid (p=<0.001) were observed in the suicide attempt group. ROC analysis indicated a significant diagnostic potential for homocysteine in predicting suicide attempts (AUC = 0.845, sensitivity = 91%, specificity = 71%). This study establishes a significant association between high homocysteine levels and suicide attempts, accompanied by lower vitamin B12 and folic acid levels. The findings suggest a potential link between disturbances in homocysteine metabolism and suicidal tendencies, urging further research to establish causation and explore therapeutic implications. Consideration of the study's limitations and directions for future research are warranted.

Homocysteine levels in first-episode patients with psychiatric disorders

A high homocysteine (Hcy) level is a risk factor for schizophrenia, depression, and bipolar disorder. However, the role of hyperhomocysteinemia as either an independent factor or an auxiliary contributor to specific psychiatric symptoms or disorders remains unclear. This study aimed to examine Hcy levels in first-episode inpatients with psychotic symptoms and various psychiatric diseases to elucidate the association between Hcy levels and psychiatric disorders. This study enrolled 191 patients (aged 18–40 years) with psychiatric disorders. Seventy-five patients were diagnosed with schizophrenia, 48 with acute and transient psychotic disorders, 36 with manic episodes with psychosis, 32 with major depressive episodes with psychosis, and 56 healthy controls. Serum Hcy levels were measured using the enzyme cycle method. A Hcy concentration level of &amp;gt; 15 μmol/L was defined as hyperhomocysteinemia. Hcy levels were significantly higher in first-episode patients with psychiatric disorders compared to healthy controls (5.99 ± 3.60 vs. 19.78 ± 16.61 vs. 15.50 ± 9.08 vs. 20.00 ± 11.33 vs. 16.22 ± 12.06, F = 12.778, P &amp;lt; 0.001). Hcy levels were significantly higher in males with schizophrenia, acute and transient psychotic disorder, and major depressive disorder but not in mania [schizophrenia, (t = -4.727, P &amp;lt; 0.001); acute and transient psychotic disorders, (t = -3.389, P = 0.001); major depressive episode with psychosis, (t = -3.796, P &amp;lt; 0.001); manic episodes with psychosis, (t = -1.684, P = 0.101)]. However, serum Hcy levels were not significantly different among the psychiatric disorder groups (F = 0.139, P = 0.968). Multivariate linear regression showed that males had an increased risk for homocysteinemia. (95% CI = 8.192–15.370, P &amp;lt; 0.001). These results suggest that first-episode patients with psychiatric disorders have higher Hcy levels than in the general population, and men are at greater risk for psychiatric disorders. In conclusion, elevated Hcy levels may contribute to the pathogenesis of first-episode patients with psychotic symptoms.