Mean Plasma Hcy Levels Research Articles

A Study of Plasma Homocysteine Level in Children with Autism

Background: Autism is a neurodevelopmental disorder that appears in early life. B6 and B12, and folate support homocysteine (Hcy) metabolism. Hence, any defect to them leads to Hcy accumulation in the body. Hcy, vitamins B12, B6 and folate are important in psychiatric disorders such dementia, schizophrenia, and autism. This study intended to compare the plasma Hcy levels in normal and autistic cases to find out whether there is difference between the levels of Hcy in plasma of autistic and normal children.
 Methods: This case control study enrolled 60 children who were allocated in two groups 30 with autism and other 30 as controls. All patients were exposed to full history taking, physical examination, mental status examination, hearing test, routine lab investigations and specific lab investigations (serum folic acid, plasma vitamin B12 and Hcy level).
 Results: Childhood Autism Rating Scale (CARS) level among autistic children was 49.400 ± 5.840. The mean plasma Hcy level was considerably higher in children with autism than controls (P value< 0. 01). The mean serum folic acid level and vit B12 level was significantly reduced in autistic cases than controls (P value< 0. 01). There was a statistically significant positive correlation between plasma Hcy level (µmol/L) and CARS level in children with autism (P value< 0. 01).
 Conclusions: Children with autism have increased levels of Hcy, and decreased levels of folic acid and vit B12. So, Hcy may be used as a clinical biomarker for early diagnosis and managing of autistic children.

Kidney function decline is associated with an accelerated increase in plasma homocysteine in older adults: a longitudinal study.

Few studies have been conducted to investigate the association of kidney function decline with the trajectories of homocysteine (Hcy) over time, using repeated measurements. We aimed to investigate the association of kidney function with changes in plasma Hcy levels over time. Data were collected from the Rugao Longevity and Ageing Study. In detail, plasma Hcy and creatinine levels were measured in both waves (waves 2, 3 and 4) during the 3·5-year follow-up (n 1135). Wave 2 was regarded as the baseline survey. The estimated glomerular filtration rate (eGFR) was calculated based on creatinine. Subjects were categorised into four groups according to quartiles of eGFR at baseline. Linear mixed-effect models were used to investigate the association of eGFR with subsequent plasma Hcy levels. The mean eGFR at baseline was 90·84 (sd 11·42) ml/min per 1·73 m2. The mean plasma Hcy level was 14·09 (sd 6·82) at baseline and increased to 16·28 (sd 8·27) and 17·36 (sd 10·39) μmol/l during follow-ups. In the crude model, the interaction between time and eGFR at baseline was significant (β = -0·02, 95 % CI -0·02, -0·01, P = 0·002). After adjusting for confounding factors, a significant relationship remained (β = -0·02, 95 % CI -0·02, -0·01, P = 0·003), suggesting that kidney function decline at baseline was associated with a faster increase in Hcy levels. Kidney function decline is associated with a more pronounced increase in plasma Hcy levels. Further studies with longer follow-up periods and larger sample sizes are needed to validate our findings.

The association between plasma homocysteine level and metabolic syndrome

Objectives:To investigate the association between plasma homocysteine (Hcy) status and metabolic syndrome (MS) among Saudi patients attending King Abdulaziz Medical City in Riyadh, Saudi Arabia.Methods:A record-based cross-sectional study of 446 patients was carried out. All consecutive plasma Hcy levels from 2015 to 2018 were extracted. International Diabetes Federation criteria for MS were used to classify the patients. A multivariate regression model was developed to examine the associations between plasma Hcy and MS.Results:The mean plasma Hcy level was 10.52 µmol/L, and 40% of the patients exhibited elevated Hcy status. Male patients had significantly elevated Hcy levels compared to female patients (p<0.001). In addition, plasma Hcy levels were significantly higher in patients diagnosed with diabetes (p=0.021) and hypertension (p<0.001). The prevalence of MS within the study population was 51%. Homocysteine levels were associated with the presence of MS independent of demographic, anthropometric and biochemical variables (odd ratio 1.018; 95% confidence intervals 1.011 -1.047).Conclusion:Plasma Hcy levels were elevated in 40% of the MS patients. Homocysteine had weak association with the presence of MS. Additionally, it was associated with some of its components individually. This study has raised the importance of investigating the association between Hcy status and MS among a representative sample of Saudi population. Additionally, examining possible association and interaction between Hcy level and specific component of MS is suggested to be explored in future studies.

Methylene tetrahydrofolate reductase and methionine synthase gene polymorphisms as genetic determinants of pre-eclampsia.

Pre-eclampsia (PE) is a leading cause of maternal and neonatal mortality in Africa; and has been associated with the interplay of genetic, metabolic and environmental factors. Polymorphisms of methylene tetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) folate cycle genes, have been controversially associated with pre-eclampsia in studies from different human populations. To determine the distribution of MTHFR C677T and MTR A2756G polymorphisms in a Nigerian population and evaluate possible associations with the occurrence of pre-eclampsia and homocysteine metabolic derangement. This study was a hospital based study carried out in Lagos, South-western Nigeria. Two hundred pregnant women clinically diagnosed with pre-eclampsia (study group) and 200 apparently healthy non-pre-eclamptic pregnant women (control group) were recruited for the study after written informed consent. Pre-eclampsia was diagnosed based on the International Society for the Study of Hypertension in Pregnancy re-classification of 2013. MTHFR C677T and MTR A2756G polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical analyzes were performed using SPSS version 23. Hardy-Weinberg distribution were tested with χ2 test. Logistic regression model was used to evaluate the relationship of variables with pre-eclampsia. A value of p<0.05 was considered statistically significant. MTHFR genotype frequencies of CC, CT and TT were 59.8%; 31.2% and 9.0% in study group and 76.6%; 22.3% and 1.0% in the control group respectively. MTR A2756G genotype frequencies of AA, AG and GG genotypes were 71.9%; 20.1% and 8.0% for the study group and 81.5%; 16.4% and 2.1% for the control group. Occurrence of pre-eclampsia was significantly associated with presence of T allele of MTHFR (OR=1.855; p<0.05) and G allele of MTR genes (OR=1.269; p<0.05), Homozygosity of TG haplotype significantly increased the occurrence of pre-eclampsia among Nigerian women (OR=2.252; p<0.05). Population attributable risk fraction percent for the T and G alleles were 16.4% and 11.5% respectively. Mean plasma Hcy level was not, however, significantly affected by MTHFR/MTR haplotypes (F=1.54; p=0.157). MTHFR C677T and MTR A2756G polymorphisms were associated with pre-eclampsia in a population of pregnant women in Lagos, Nigeria.

Methylenetetrahydrofolate Reductase Enzyme Level and Antioxidant Activity in Women with Gestational Hypertension and Pre-eclampsia in Lagos, Nigeria.

Deficiencies of enzymes in the folate cycle may lead to the generation of homocysteine, a toxic metabolic intermediate with pro-oxidant effect and ability to induce oxidant stress and lipid peroxidation as part of the pathophysiological process in gestational hypertension (GH) and pre-eclampsia (PE). The aim of this study is to assess the reliability of plasma homocysteine (hcy) 5, 10 methylenetetrahydrofolate reductase (MTHFR) enzyme and oxidative stress parameters as indicators of aetio-pathogenesis and severity of gestational hypertension and pre-eclampsia. This was a comparative cross-sectional study conducted over 6months. Two hundred pregnant women were recruited from two sites. They were divided into gestation hypertension (n = 40), pre-eclampsia (n = 60) and control groups (n = 100). Parameters evaluated for statistical analysis were MTHFR enzyme level, plasma homocysteine and malondialdehyde (MDA) levels, with glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) activities. Mean plasma hcy level and MDA were significantly higher in pre-eclampsia and gestational hypertension when compared to control group (p < 0.05). However, MTHFR enzyme level, GSH, SOD and CAT were significantly higher in normotensive females when compared to PE and GH subgroups (p < 0.05). Pre-eclampsia was significantly associated with an increased risk of lipid peroxidation (OR = 4.923; p = 0.007). Pre-eclampsia and gestational hypertension are associated with marked homocysteine metabolic derangement and increased lipid peroxidation induced by oxidative stress and reduced MTHFR enzyme activity which may be the significant risk factors in the aetio-pathogenesis of GH and PE.

Homocysteine in retinal artery occlusive disease: A meta-analysis of cohort studies

Few studies have reported the relationship between retinal artery occlusion (RAO) and plasma homocysteine (Hcy) levels. Our goal was to evaluate the association between the plasma Hcy level and the risk of RAO disease. Several databases were searched for all published studies that involved Hcy and RAO. Six studies evaluated hyperhomocysteinemia (hHcy) in retinal artery occlusion patients and controls; the incidence of hHcy in patients with RAO was higher than the control and the pooled odds ratio (OR) was 6.64 (95% confidence interval (CI): 3.42, 12.89). Subgroup analyses showed that the ORs were 4.77 (95% CI: 2.69, 8.46) in Western countries, 22.19 (95% CI: 2.46, 200.37) in Asian countries, 9.70 (95% CI: 4.43, 21.20) in the age matched group, 11.41 (95% CI: 3.32, 39.18) in the sex matched group, 9.70 (95% CI: 4.37, 21.53) in the healthy control group, and 6.82 (95% CI: 4.19, 11.10) in the sample size >30. The mean plasma Hcy level from 5 case-control studies was higher than controls, and the weighted mean difference (WMD) was 6.54 (95% CI: 2.79, 10.29). Retinal artery occlusion is associated with elevated plasma Hcy levels. Our study results suggest that hHcy is probably an independent risk factor for RAO.

Association Between Plasma Homocysteine and Microalbuminuria in Untreated Patients with Essential Hypertension: a Case-Control Study

Background/Aims: Kidney function is critical for homocysteine (Hcy) clearance, and plasma Hcy levels are frequently increased in patients with renal failure. Microalbuminuria (MAU) is an important marker of early renal damage caused by hypertension. At present, there is insufficient evidence on the relationship between Hcy and microalbuminuria. Methods: This is a 1: 2 matched, hospital-based case-control study. At initial visit, out of 1535 outpatients with no prior history of medication, 450 qualified subjects were selected based on inclusion and exclusion criteria. The concentration of Hcy in the serum was evaluated using a cyclic enzyme method. MAU was defined by a urine albumin/creatinine ratio (UACR) between 30 μg/mg and 300 μg/mg. Results: A total of 450 patients were included in this study (150 in the MAU group and 300 in the non-MAU group). The MAU group had higher mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), heart rate (HR) and plasma Hcy levels than did the non-MAU group. The area under the receiver operating characteristics (ROC) curves was 0.772 (95% CI: 0.724–0.819, P < 0.001) with a cut-off value of 15.0, and the sensitivity and specificity of Hcy in predicting the MAU status in hypertensive patients were 49.3% and 92.3%, respectively. Multiple logistic regression modelling suggested that patients with a higher Hcy level (> 15 µmol/L) were more likely to have MAU (95% CI: 5.650–16.543, P < 0.001). The other predictive factor for MAU was 24-h mean SBP (95% CI: 0.941–0.993, P = 0.015). Conclusion: This matched case-control study indicates that Hcy may increase the susceptibility of essential hypertensive subjects to MAU.

The Associations of MTHFR C677T Mutation and Plasma Homocysteine Level with Carotid Intima-Media Thickness

Background and Objective: Mild hyperhomocysteinemia has emerged as a risk factor for atherosclerosis. The genetic data of 5,10 methlenetetrahydrofolate reductase (MTHFR), a regulatory enzyme of homocysteine (Hcy) metabolism, among South-East Asian is conflicting and not often especially of cardiocerebrovascular disease subjects. Methods: This study measured carotid IMT, fasting plasma Hcy and analyzed the MTHFR C677T genotype in cross sectional study of 40 hypertensive Malayan race > 45 yrs of age with acute ischemic stroke in Palembang Indonesia. Biochemical data were obtained within the first 48 hours of stroke onset. Subjects with previous history of CVD, malignancy, renal failure and DM were excluded. Results: MTHFR 677T/T mutation was observed in 3/40 (7.5%), heterozygocity was 25.0% and T allele was 0.20. Mean plasma Hcy level was found as 8.5 ± 4.16 μmol/L and it was associated to MTHFR C677T genotype. Plasma Hcy level was significantly higher among subjects with TT genotype compared to CC (mean [±SD] 15.58 ± 2.70 μmol/L vs 7.72 ± 3.80 μmol/L, p = 0.002) and CT genotype (15.58 ± 2.70 μmol/L vs 8.48 ± 3.62 μmol/L, p = 0.01), but there was no significantly association between CC and CT genotype (p = 0.58). after adjusting for age and sex, there was no association between MTHFR C677T genotype or plasma Hcy level and increased of IMT or presence of carotid plaque (p > 0.05). Conclusions: There was significantly association between the MTHFR C677T mutation and plasma homocysteine level. There was no association between both and carotid IMT or plaque.

Methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and alcohol consumption in hyperhomocysteinaemia: a population-based study from northeast India

Chronic alcohol consumption is often found to be associated with hyperhomocysteinaemia through inhibiting methionine synthase. Moreover, single nucleotide change in MTHFR C677T gene also leads to hyperhomocysteinaemia. A total of 598 unrelated individuals (case = 451; control = 147) aged 25–70 years were screened for MTHFR C677T polymorphism by polymerase chain reaction (PCR) amplification followed by restriction enzyme digestion. Plasma homocysteine (Hcy) levels were measured using chemiluminescence technique to understand the role of both alcohol consumption and 677T allele independently and in combination in the causation of hyperhomocysteinaemia. Results indicate a relatively higher frequency of 677T allele among cases. Both cases and controls show higher mean plasma Hcy levels (>25 μmol/L), however, difference was not statistically significant. Individuals carrying mutant 677T allele did not show significant difference for Hcy level in both the groups. However, caseswith mutant TT genotype presented significant increase in Hcy level. Neither 677T allele, nor alcohol consumption is found to predispose individuals to higher homocysteine levels. However, TT genotype coupled with alcohol consumption leads to significant increase risk of Hcy levels. Chronic alcohol consumption is one of the leading health risks and according to WHO (2011) it is world’s third largest risk factor for disease and disability. More than 60 disease conditions have been reported to be associated with alcohol consumption (Gmel and Rehm 2003). Alcohol consumption is often found to be associated with hyperhomocysteinaemia, i.e., elevation of

Preliminary report on plasma homocysteine and hormonal variations in infertile women in Lagos, Nigeria

Background: The relationship between infertility and hormonal variations has been variously documented, but little has been reported on the interactions between hormonal factors, homocysteine (Hcy), and female infertility. Objective: This study aimed to evaluate the relationship between plasma Hcy levels and hormonal variations in infertile women. Materials and Methods: This descriptive cross-sectional study was carried out among eligible infertile and fertile women seeking care at the Lagos University Teaching Hospital, Lagos, Nigeria. The subjects were 100 women referred for management of infertility, and the controls were 50 fertile women who had given birth within the past year. Fasting plasma levels of Hcy were estimated using enzyme immunoassay. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, and progesterone were measured using Access 2 (Immunoassay systems-beckman coulter, inc.250S.Kraemer blvd.Brea, ca 92821. U.S.A). Results: Mean plasma Hcy levels for subjects and controls were 9.50 ± 1.88 μmol/L and 9.44 ± 1.85 μmol/L, respectively, with no significant variation (P = 0.952). Plasma Hcy was not significantly associated with infertility and hormone levels. The mean serum levels of LH, FSH, and prolactin were significantly higher among subjects compared to controls. Conclusion: Hormonal variations observed in infertile women did not appear to significantly alter plasma Hcy levels, and hyperhomocysteinemia (HHcy) may not have significantly contributed to female infertility in our environment.

Hyperhomocysteinaemia, low folate concentrations and MTHFR C677T mutation in abdominal aortic aneurysm.

Homocysteine (Hcy) has been implicated in abdominal aortic aneurysm (AAA). However, the association of Hcy, vitamin B12, and folate in patients with AAA has not been studied in China. This study was conducted with the aim to evaluate the relationship of vitamin B12, folic acid, and Hcy levels in AAA. 463 patients who had AAA were included in this study. 463 control subjects were age- and sex-matched with the patients. In all of the subjects, we evaluated total plasma levels Hcy, vitamin B12, folic acid and the distribution of the C677T methylenetetrahydrofolate reductase (MTHFR) gene mutation. The mean plasma Hcy levels were significantly higher in patients with AAA compared with controls (18.37 ± 6.97 vs. 12.89 ± 4.08 μmol/L, P < 0.001). The frequency of homozygous (TT) genotype in MTHFR C677T mutation was significantly higher in patients with AAA than that in control subjects (19.4 % vs. 11.9 %, P = 0.002). The fasting Hcy correlated negatively with folate (AAA: r = - 0.311, P < 0.01; r = - 0.348, P < 0.01). The aneurysm size was significantly greater (P < 0.001) in patients with hyperhomocysteinemia than that in patients with normal Hcy plasma levels. The size of the AAA had a linear correlation with the plasma Hcy level (r = 0.286; P< 0.001). Serum folate deficiency and hyperhomocysteinemia were associated with an increased risk of AAA in Northeast China. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in AAA.

Methylenetetrahydrofolate Reductase (C677T and A1298C) Polymorphisms, Hyperhomocysteinemia, and Ischemic Stroke in Tunisian Patients

The present study evaluated the role of the methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C gene polymorphisms and correlated these results with plasma homocysteine (Hcy) levels in Tunisian ischemic stroke (IS) patients. Overall, 84 patients with IS were included and compared with 100 healthy controls. The most common stroke risk factors were investigated. Fasting plasma Hcy levels were measured. Genotyping of the MTHFR C677T and A1298 polymorphisms was studied by polymerase chain reaction. Aside from tobacco and alcohol use, the other studied factors were significant risk factors for IS. Mean plasma Hcy levels were significantly higher in IS patients than in controls (16.1 ± 8.28 μmol/L versus 8.76 ± 3.48 μmol/L, P < 10(-3)). Significant associations were found with both the MTHFR 677(CT + TT) and 1298 (AC + CC) genotypes in comparison with controls (P < 10(-3)). A significant synergistic interaction was also found with the double heterozygote MTHFR 677CT/1298AC (P < 10(-3)). Homocysteine levels were significantly higher in IS patients with the MTHFR C677T variant (CT and TT genotypes) (P < 10(-3)); however, the difference was not significant with the MTHFR A1298C variant (AC and CC genotypes) (P = .31). The MTHFR C677T and A1298 polymorphisms (individually or in concert) and hyperhomocysteinemia represent important risk factors for IS. Elevated Hcy levels were found to be associated with the MTHFR C677T variant; however, no significant association was found with the MTHFR A1298C variant.

Relationship of cognitive function with plasma homocysteine, folate, vitamin B12 levels and nutrient intake in cognitively impaired elderly

This study investigated the relationship of cognitive function with plasma homocysteine (Hcy), folate, vitamin B12 levels and nutrient intake. A total of 321 subjects, including 121 normal subjects, 100 each from mild cognitive impairment (MCI) and Alzheimerˈs disease (AD) patients participated in this study (age 60 yrs and over). Diagnostic assessments were administered using the Korean version of Consortium to Establish a Registry for Alzheimerˈs Disease. Dietary intake was assessed using 24‐hour recall. Mean plasma Hcy level was higher in AD and MCI compared to normal subjects. AD group also had higher proportion of hyperhomocysteinemia and folate deficiency. Plasma Hcy level was negatively correlated with plasma folate and vitamin B12 levels, total intake of vitamin B2, vitamin B6, folate, vitamin B12, vitamin C and vitamin E. Multiple regression analysis with covariates revealed that plasma Hcy level was negatively, whereas plasma folate level, total intake of vitamin B2, vitamin B6, folate, vitamin C, vitamin E and beta‐carotene were positively associated with cognitive function. The results suggest that plasma Hcy, B vitamins and antioxidants intake are associated with cognitive function, and plasma Hcy level is negatively correlated with B vitaminsˈ nutritional status and antioxidants intake.This work was supported by the Brain Korea 21 project.

Folate, Homocysteine, Vitamin B12, and Polymorphisms of Genes Participating in One-Carbon Metabolism in Late-Onset Alzheimer's Disease Patients and Healthy Controls

We screened 378 late-onset Alzheimer's disease (LOAD) patients and 308 matched controls for the presence of the common MTHFR 677C>T, MTRR 66A>G, MTR 2756 A>G, and TYMS 28 bp repeat polymorphisms, searching for association with disease risk and age at onset. Moreover, we searched for correlation between each of the studied polymorphisms and available data on plasma homocysteine (Hcy), serum folate, and vitamin B12 values. We observed a significant increased frequency of the MTHFR 677T allele (0.48 vs. 0.42; p=0.019) and of MTHFR 677CT (OR=1.46; 95%CI=1.03-2.06) and TT genotypes (OR=1.62; 95%CI=1.05-2.49) in LOAD subjects with respect to controls. We also observed a significant increased frequency of the MTRR 66G allele (0.49 vs. 0.43; p=0.044) and of the MTRR 66GG genotype (OR=1.57; 95%CI=1.01-2.46) in the LOAD group. Significantly increased mean plasma Hcy levels (22.7±1.7 vs 14.5±1.7 μmol/L; p=0.037) and decreased serum folate values (5.7±0.5 vs. 7.8±0.8 ng/mL; p=0.005) were observed in LOAD subjects with respect to controls, whilst the difference in serum vitamin B12 values did not reach statistical significance. Several interactions between the studied polymorphisms and biochemical biomarkers were observed. None of the studied polymorphisms was associated with disease age at onset. The present study suggests that the MTRR 66G allele might contribute to LOAD risk and confirms an increased frequency of the MTHFR 677T allele in LOAD. Overall, present results support a contribution for one-carbon metabolism to LOAD pathogenesis.

Psödoeksfoliyasyonlu Olgularda Plazma Homosistein Düzeyleri

Objective: To evaluate plasma homocysteine (Hcy) levels in patients with pseudoexfoliation syndrome, pseudoexfoliation glaucoma, primary open angle glaucoma and healthy control subjects. Material and Methods: Twenty patients with primary open angle glaucoma (POAG), twenty patients with pseudoexfoliation (PEX) glaucoma, twenty patients with PEX syndrome and twenty control subjects were enrolled. Mean plasma Hcy levels of four groups were determined using high-performance-liquid-chromatography and were compared. Then all participants were classified into two groups as subjects with or without PEX and were compared. Patients who had any history of a systemic disease known to be associated with high plasma Hcy levels and taking vitamin B supplements within the previous year were excluded. Results: Of the 80 patients, 43 were females (53.75%) and 37 were males (46.25%). Mean age was 69.11±8.53 years. Mean plasma Hcy levels were 19.02±10.66 µmol/l, 19.13±17.76 µmol/l, 10.58±3.50 µmol/l and 9.92±2.59 µmol/l in patients with PEX syndrome, PEX glaucoma, POAG and control subjects, respectively. Hcy levels in patients with PEX glaucoma were significantly higher when compared to POAG patients and the control group (p=0.025, p=0.004, respectively). Hcy levels in patients with PEX syndrome were also significantly higher when compared to POAG patients and the control group (p=0.001, p=0.000, respectively). Hcy levels in patients with POAG were not statistically different from the control group (p=0.365). When the patients were classified into two groups as subjects with or without PEX, mean plasma Hcy levels were found as 19.08±14.44 µmol/l and 10.25±3.06 µmol/l, respectively (p=0.000). Conclusion: Hcy levels were found to be significantly higher in PEX with or without glaucoma.

Hyperhomocysteinaemia, Low Folate Concentrations and Methylene Tetrahydrofolate Reductase C677T Mutation in Acute Mesenteric Venous Thrombosis

Objectives Acute mesenteric venous thrombosis (AMVT) was first reported by Fagge and was recognised as a distinct clinical entity by Warreen in 1935. However, its pathogenesis is still unclear. Elevated plasma levels of homocysteine (Hcy) are associated with an increased risk of deep vein thrombosis. This case-control study examines the potential association among hyperhomocysteinaemia (hyper-Hcy), low serum folate and vitamin B 12 levels and the common C677T mutation of the MTHFR gene in patients with AMVT. Materials and methods Sixty-three patients with AMVT and 75 sex- and age-matched healthy controls were recruited, and their plasma Hcy, folate and vitamin B 12 levels were measured by high performance liquid chromatography (HPLC) and immunological assays. The polymorphism of MTHFR C677T was detected by PCR-RFLP. Results The mean plasma Hcy levels were significantly higher in patients with AVMT compared with controls (23.5 standard deviation (S.D.) 8.8 vs. 12.6 ± 6.6 μmol l −1, P < 0.01). The fasting Hcy correlated negatively with folate (AMVT: r = −0.42, P < 0.01; Control: r = −0.40, P < 0.01). The frequency of homozygous (TT) genotype in MTHFR C677T mutation was significantly higher in patients with AMVT than that in control subjects (33% vs. 17%; chi square (χ 2) = 6.31, P < 0.05; odds ratio (OR) = 2.80; 95% confidence interval (CI): 1.25–6.25). Compared with the control subjects, the mean serum vitamin B 12 levels were lower in patients, but it was not statistically significant (365 ± 88 pmol l −1 vs. 408 ± 108 pmol l −1, P > 0.05). Conclusions Hyper-Hcy and low serum folate levels were associated with an increased risk of AMVT. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in the development of AMVT for a Chinese population.

Is Plasma Homocysteine Level Associated With Metabolic Syndrome Components in Adolescents?

This study investigated whether serum homocysteine (Hcy) level is associated with metabolic syndrome components, including high waist circumference (WC), hypertriglyceridemia, low high-density lipoprotein-cholesterol (HDL-C), elevated systolic blood pressure (SBP), and insulin resistance (IR) in adolescents living in Central Anatolia, Turkey. The data of The Prevalence of Metabolic Syndrome Among Adolescents Study, a cross-sectional study carried out in two of the central and ten outlying districts of Kayseri was used. Components of metabolic syndrome were modified from the Adult Treatment Panel III (ATP III). A multivariate regression model was developed to examine the relationships between the homocysteine (Hcy) level and metabolic syndrome components. Hyperhomocysteinemia (HH) was defined as level of Hcy > or = 15 micromol/L. Mean plasma Hcy level of adolescents with metabolic syndrome was found to be 11.8 +/- 5.0 micromol/L. Although the Hcy level of females (11.4 +/- 5.5 micromol/L) was lower than that of males (12.0 +/- 4.7 micromol/L), the difference was not statistically significant (P > 0.05). In all, 40.5% of adolescents had Hcy levels between 10 and 15 micromol/L (mild HH) and 17.7% of adolescents had Hcy levels of > or = 15 micromol/L. The Hcy level was negative and weakly correlated with insulin resistance in females (r = -0.319, P = 0.058) and negative strongly correlated with SBP in males (r = - 0.385, P = 0.011). There were no associations between Hcy level and other components of metabolic syndrome. An elevated plasma Hcy level is not considered to be related to components of metabolic syndrome. But HH may be an independent risk factor, especially for diabetic adolescents or those who have cardiovascular events as in adults.

Strontium ranelate decreases plasma homocysteine levels in postmenopausal osteoporotic women

We analyzed the effect of strontium ranelate treatment on plasma homocysteine (Hcy) levels in postmenopausal osteoporotic women. Forty-nine postmenopausal women diagnosed with osteoporosis with a mean age of 54.07 +/- 7.5 years (range 40-70) who visited our menopause clinic were participated in this prospective study. Patients with bone mineral density (BMD) at least 2.5 SD below the average value in young adults (T score < -2.5) were considered to have osteoporosis. Patients received strontium ranelate 2 g/day (Servier) orally with additional calcium supplements. Fasting plasma Hcy levels were assessed at baseline, 3, 6 and 12 months of the therapy with strontium ranelate. The mean plasma Hcy level (10.45 micromol/l) after 3 months of therapy was significantly lower compared to the basal plasma Hcy level (12.61 micromol/l) (P = 0.002). The plasma homocysteine level (10.54 micromol/l) of the 43 patients that were present at the 6 months of the therapy was also significantly lower compared to the basal plasma Hcy level (P = 0.005). At the end of the 12 months of the study, there were 42 patients. The plasma homocysteine level (10.107 micromol/l) at 12 months of therapy was also significantly lower compared to the basal Hcy level (P < 0.001). Strontium ranelate 2 g/day treatment for 1 year significantly decreases plasma Hcy levels in postmenopausal women with osteoporosis. Since the increased Hcy levels could lead to an increase risk of osteoporosis and fracture risk, this effect of strontium ranelate on Hcy level may cause additional benefit in terms of reducing the risk of fracture.

Hyperhomocysteinemia in patients with symptomatic chronic heart failure: Prevalence and prognostic importance—pilot study

Background Patients with chronic heart failure (CHF) may be particularly susceptible to unfavorable effects of hyperhomocysteinemia (HHcy). The aim of this study was to assess the prevalence of HHcy (plasma homocysteine [Hcy] ≥ 14 μmol/L) in an unselected cohort of CHF patients, its clinical determinants, and prognostic implications. Methods and Results In 108 consecutive CHF patients (81 men, age: 66 ± 11 years) with mean plasma Hcy level 12.5 ± 5.5 μmol/L (range 2.3–28.3 μmol/L), 38 (35%) patients demonstrated HHcy. Among clinical and metabolic parameters, in multivariable regression models, advanced NYHA class ( P < 0.0001), plasma NT-proBNP ( P < 0.001), peak oxygen consumption ( P < 0.05), reduced glomerular filtration rate ( P < 0.0001) and elevated serum uric acid ( P < 0.05) predicted high plasma Hcy level. HHcy was related to increased mortality (HR = 3.26, 95% CI: 1.78–5.98, P = 0.0001), also when adjusted for conventional prognosticators in multivariable models (all P < 0.01). In patients with HHcy, a 3-year survival was 37% (95% CI: 22–52%) as compared to 73% (95% CI: 63–83%) in those with normal Hcy levels ( P < 0.0001). Conclusions HHcy is common in CHF, is related to the disease severity, depicts generalized metabolic imbalance (evidenced by hyperuricaemia), and independently predicts poor long-term prognosis.

Elevated plasma homocysteine levels in L-dopa-treated Parkinson's disease patients with dyskinesias

Elevated plasma homocysteine (Hcy) concentrations are associated with increased risk of systemic vascular diseases, Alzheimer's disease and vascular dementia. Several cross-sectional reports and two prospective clinical studies have recently reported elevated plasma Hcy levels in L-dopa-treated Parkinson's disease (PD) patients and Hcy has been proposed as a possible mediator for the development of long-term L-dopa motor complications (such as wearing off and on-off phenomena, and dyskinesias). The aim of the study was to elucidate a possible role of L-dopa-related hyperhomocysteinemia in the development of dyskinesias. In this cross-sectional study we compared Hcy, B(12) and folate levels in 53 PD patients treated with L-dopa (29 with dyskinesias, 24 without dyskinesias). Mean plasma Hcy levels were higher in the group of PD patients with dyskinesias (19 vs. 15.4 micromol/L; T: 2.12; p=0.04). After taking into account potential confounding factors, analysis of the data revealed that the occurrence of dyskinesias progressively increased with plasma Hcy levels (relative risk 1.2, 95% CI 1.015-1.4; p=0.03). Our results raise the possibility that Hcy plays a role in the development of dyskinesias, through its toxic effects on both dopaminergic neurons and non-substantia nigra, non-dopaminergic neurons.