Mean Serum Homocysteine Research Articles

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<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<0.001). Significant correlation was found between serum folic acid and serum homocysteine levels, and glycosylated hemoglobin (p<0.05 and p<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.

Role of hyperhomocysteinemia in the progression of diabetic retinopathy

: The aim of this study was to determine the role of hyperhomocysteinemia in the progression of diabetic retinopathy and to determine the association of hyperhomocysteinemia with various grades of diabetic retinopathy.Diabetic retinopathy is the most common ocular complication of Diabetes mellitus. Various studies have shown that mild elevations of homocysteine in plasma are associated with an increased risk of vaso-occlusive disease, thrombosis, and stroke.: A total of 97 patients who were diagnosed with diabetic retinopathy from October 2018 to September 2019 were included in our study. Written informed consent was taken from all the participants. Best corrected visual acuity (BCVA), anterior segment examination using slit lamp biomicroscopy examination(SLE), fundoscopy using indirect ophthalmoscope and using 90D lens on slit lamp was done in all patients. Serum homocysteine was assessed in all. The data was analysed using SPSS version 17.0. Results were expressed as mean, frequency and percentage. Out of 97 patients, mean serum homocysteine seen in mild non proliferative diabetic retinopathy, moderate non proliferative diabetic retinopathy, severe non proliferative diabetic retinopathy and proliferative diabetic retinopathy was 13.8 ± 0.33, 14.6 ± 0.44, 14.64 ± 0.41 and 15.78 ± 1.33 respectively.: In our study we found serum homocysteine levels was elevated in proliferative diabetic retinopathy when compared to non-proliferative diabetic retinopathy.

Elevated Serum Homocysteine Concentrations in Severe Preeclampsia and Eclampsia

Background & objective: Preeclampsia, a pregnancy-specific syndrome, is a major cause of maternal and perinatalmorbidity and mortality all over the world. Several studies have indicated that homocysteine concentrations areincreased in women with preeclampsia. However, there is still conflicting evidence on the extent to which elevatedmaternal homocysteine contributes to this deadly complication of pregnancy. The present study was, therefore,intended to see the association between serum homocysteine and preeclampsia. Methods: This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology, Dhaka MedicalCollege Hospital, Dhaka over a period of 2 (two) years from July 2007 to June 2009. Pregnant women with gestationalage ranging between 24 – 40 weeks having preeclampsia or eclampsia were considered as cases, while gestationalage-matched pregnant women without preeclampsia and eclampsia were considered as controls. However, pregnancywith diabetes mellitus, known renal or hepatic disease, urinary tract infection, cardiovascular disease, and takinganti-epileptics were excluded from the study. A total of 100 pregnant women – 50 cases and 50 controls were selectedfor the study. Among the cases, 16 had mild preeclampsia, 17 had severe preeclampsia, and 17 had eclampsia. Result: Two-thirds of the cases and 60% of the controls were in their 3rd decade of life with no significant differencebetween the study groups (p = 0.651). There was no significant difference between the groups in terms of gravidityand gestational age. However, the past history of PE demonstrated its more significant presence in the case group thanthat in the control group (p = 0.030). Out of 50 cases, 30(60%) had severe proteinura (+++), 15(30%) had moderateproteinuria (++) and 5(10%) had mild proteinuria. The mean serum homocysteine level was significantly higher inmild PE (7.2±1.2 μmol/L) than that in normal pregnant women (5.3±1.0 μmol/L). The concentration of homocysteineincreases with the increase in severity of preeclampsia (p = 0.004) and turning preeclampsia into eclampsia (p =0.027). The data show as the grade of proteinuria increases progressively (from mild to severe) the concentrations ofhomocysteine level also increase progressively from 6.3 ± 1.6 μmol/L in mild proteinuria to 11.4 ± 3.7 μmol/L insevere proteinuria. Conclusion: The serum homocysteine level is significantly elevated in mild PE than that in normal pregnant women.The concentration of homocysteine increases further with the increase in the severity of preeclampsia and ineclampsia. Ibrahim Card Med J 2022; 12 (2): 10-14

Association between Plasma Homocysteine Level and Atherogenic Index of Plasma among Hypothyroid Patients - A Case-Control Study

Introduction: Hypothyroidism is a common metabolic disorder in general population. Hypothyroidism is a commonly encountered health problem in Bangladesh and morbidity and mortality toll due to cardiovascular disease resulting from hypothyroidism is quite high. Hypothyroidism, dyslipidaemia and hyperhomocysteinemia are recognized risk factor for atherosclerosis and cardiovascular disease. Aim of the Study: The aim of this study was to evaluate the association between plasma Homocysteine level and atherogenic Index of plasma in patients with hypothyroidism. Methods: This was a case-control study and conducted in the Department of Biochemistry in cooperation with Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from January, 2012 to December, 2013. In our study, we included 60 newly diagnosed hypothyroid individuals as case and 60 euthyroid individuals as control. Result: In this study, most of the participants were female (62%) compared to male (38%) and we found the mean age of the case and control group was 34.31 ± 11.77 years and 32.42 ± 12.51 years. Mean serum homocysteine was found significantly higher in case group (19.00 ± 7.58 µmol/L) than control group (9.59 ± 1.91µmol/L).Mean AIP was found significantly higher in case (0.75 ± 0.27) than control (0.35 ± 0.20). We found 49 (81.67%) cases were within increased risk group of atherogenesis where as in control group it was 28 (46.67%).In present study, mild hyperhomocysteinemia was found in 80% cases and moderate hyperhomocysteinemia in 13.3% cases where as in control group it was 10% & 0% respectively. Conclusion: In this study, we found that total plasma homocysteine level was significantly increased in recently diagnosed hypothyroidism and was normal in control groups. We also found that hypothyroidism is associated with high atherogenic index and hyperhomocysteinemia which causes premature atherosclerosis.

Association of Elevated Serum Homocysteine Level in Women with Gestational Diabetes Mellitus

Background: In gestational diabetes mellitus (GDM), risk prediction is mostly based on maternal history and clinical risk factors and may not optimally identify high risk pregnancies. Therefore, universal screening is widely recommended. Homocysteine levels during pregnancy in women with GDM have been studied; however, it remains unclear whether hyperhomocysteinemia is a useful predictor of GDM. Objective: To determine the association of serum homocysteine level in women with gestational diabetes mellitus. Methods: Case control study was conducted in the Department of Obstetrics and Gynaecology, Institute of Child and Mother Health (ICMH), Dhaka. Pregnant women in their 24 weeks to 40 weeks of gestation attended for antenatal care diagnosed as GDM was selected as cases. Non- diabetic pregnant women matching with cases by age and gestational age were selected as control in this study. GDM was diagnosed by oral glucose tolerance test (OGTT). The serum homocysteine level of these patients was measured. Descriptive and inferential analysis was carried out using SPSS version 22.0. P-value less than 0.05 will be considered as statistically significant. Results: Among the cases fasting blood sugar (6.13 ± 0.66) and controls (4.60 ± 0.57). Similarly, 2 hours after 75 gm. glucose blood sugar among cases (8.46 ± 0.88) and controls (6.32 ± 0.96). Both results were statistically significant p=0.001. Majority of patients were at third trimester of pregnancy (67.0%). 37.5% were primigravida and 2.5% were multigravida. Mean gestational age of cases (30.25 ± 2.74) and controls (30.02 ± 3.03). Among the cases 62.1% had history of GDM where 37.9% don’t have history of GDM. Among control group only 7.7% had history of GDM. This result statistically significant p=0.001. 6.9% cases had history of macrocosmic child which was not statistically significant p=0.49. There was no history of still birth or other congenital defect. Mean serum homocysteine level among cases (6.50 ± 1.72) and controls (5.20 ± 1.87) which was statistically significant p=0.001. Positive correlation observed between maternal serum homocysteine level and maternal blood sugar (r=0.209, p=0.005) in this study. Respondents with high homocysteine level have 3.94 times more chance to develop GDM (OR=3.94; 95% CI = 1.59-9.77). Conclusion: Finding from the present study suggests that maternal elevated serum homocysteine level in pregnancy is significantly associated with Gestational Diabetes Mellitus.

Relationship between homocysteine and cognitive impairment in elderly patients with chronic kidney disease

<b>Aim:</b> To investigate the association of serum homocysteine levels with cognitive function in elderly patients with chronic kidney disease (CKD).<br /> <b>Methods:</b> A case-control study on 200 elderlies >60 years who were distributed into two groups: group 1 (cases): 100 patients with CKD and group 2 (controls): 100 subjects who do not have CKD. All subjects undergo comprehensive geriatric assessment, cognitive assessment, and biochemical investigations including serum homocysteine.<br /> <b>Results:</b> The odds ratio of having impaired clinical dementia rating scores is 3.1 for CKD cases compared to controls. CKD patients have almost 3 times the risk of having cognitive impairment [OR=3.1; 95% CI (1.6-6.0)]. The mean serum homocysteine (18.2 μmol/L) among CKD showed a highly statistically significance compared to controls (10.1 μmol/L). Performance of multiple cognitive domains was reduced in association with elevated homocysteine levels. By using linear regression model for the factors independently related to cognitive performance among studied CKD cases, it was found that diabetes mellitus, educational level, age, and serum homocysteine level were strongly associated with consortium to establish a registry for Alzheimer’s disease neuropsychological battery total scores. Respecting the percentage variance explained by each significant variable (R<sup>2</sup>), serum homocysteine level is an independent significant variable predictor with the total scores.<br /> <b>Conclusion:</b> The main features of cognitive impairment in CKD patients are executive dysfunction and memory impairment. Poor cognitive function in CKD patients was related with a higher homocysteine level independently.

A Hospital-Based Case-Control Study on Raised Homocysteine Level in Vitiligo Patients and Its Association With Disease Severity.

Introduction Vitiligo is an acquired pigmentary disorderclinically manifested by circumscribed depigmented macules and often associated with leucotrichia. Not much is known about the biochemical abnormality occurring in vitiligo. Our study aims to determine whether serum homocysteine is raised in vitiligo patients and whether it can be used as a prognostic marker for vitiligo. Material and methods This study is a hospital-based, case-control, analytical study conducted on 70 patients of vitiligo patients. A total of 30 staff of the hospital served as control. Venous blood was withdrawn from the antecubital vein from all study participants using all aseptic precautions. Investigation of blood homocysteine levels was done in all the study participants. Scoring of vitiligo was done based on Vitiligo European Task Force (VETF) criteria which takeinto account body surface area, stage, and spread. Results Mean serum homocysteine level among vitiligo patients was 14.40± 5.80 micromoles/lit as compared to 10.33± 5.05 micromole/lit in control groups, and this difference was statistically significant (t-value = 3.19and p-value = 0.002). The correlation coefficient was statistically significant (correlation coefficient = 0.25 and p-value = 0.03) in between homocysteine level and stage of the disease. On multiple comparisons difference in serum homocysteine level of progressing category is significantlyraised as compared to control, stable, and regressing categories. Conclusion The mean serum homocysteine level among all vitiligo patients was higher as compared to control groups. Moreover, the serum homocysteine level of active cases is significantly higher as compared to control, stable, and regressing categories. Also, serum homocysteine levels showed a positive correlation with the degree of depigmentation, i.e., stage of the disease.

Association of serum homocysteine with type II diabetic retinopathy.

Objective: To elucidate the association of serum homocysteine with diabetic retinopathy. Study Design: Case Control study. Setting: Department of Physiology and Centre for Research in Experimental and Applied Medicine (CREAM), Army Medical College, in Collaboration with Armed Forces Institute of Ophthalmology, Rawalpindi. Period: December 2019 to December 2020. Material & Methods: A total of ninety subjects were enrolled in the study which were subdivided into three groups; healthy subjects, diabetic subjects and patients with diabetic retinopathy (DR). The permission for carrying out the study was obtained from ethical review committee. Confidentiality of the data was maintained. The data obtained was analyzed and processed using SPSS software. Results: The mean Fasting Blood Glucose (FBG) levels were found to be 5.51 ± 0.34 (mmol/l), 8.11 ± 0.67 (mmol/l) and 8.73 ± 0.90 (mmol/l) in healthy controls, diabetic subjects and patients with DR respectively (p=0.001). The mean serum homocysteine levels were found to be 10.12 + 1.95 (µmol/l), 24.99 ± 4.25 (µmol/l) and 45.78 + 9.66 (µmol/l) in healthy controls, diabetic subjects and patients with DR respectively (p=0.001). Conclusion: Our research can be concluded that serum homocysteine levels have a strong association with the development of diabetic retinopathy. Monitoring the serum levels of this inflammatory biomarker can therefore be helpful in obviating the development of diabetic microangiopathic complications, particularly diabetic retinopathy. Serum homocystein can be used a prognostic tool in the progression of microangiopathic complications of diabetes.

Evaluation of serum folate, vitamin B12 and homocysteine among blood donors in Lagos State University teaching hospital, Lagos, Nigeria

<p><strong>Background: </strong>Folate, vitamin B12 deficiency and hyperhomocysteinaemia have been reported as important risk factors for the development of cardiovascular events and ischaemic stroke. These vitamin deficiencies are also implicated in the pathogenesis of several diseases like anaemia, dementia, Alzheimer’s disease and cancers. This study determined the serum levels of vitamins B12, folate, and homocysteine among blood donors in the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.<strong></strong></p><p><strong>Methods: </strong>This was a descriptive, cross-sectional study done among blood donors at the donor clinic of LASUTH Ikeja, Lagos, Nigeria. One hundred blood donors who met the donor inclusion criteria of LASUTH were recruited consecutively into the study.<strong> </strong>Five ml of venous blood was collected from each consenting participant into ethylene Diamine Tetra-acetic Acid (EDTA) and plain bottles for the determination of full blood count and folate, vitamin B12/homocysteine respectively. Data were analyzed with statistical package for social science version 23.0, the p value was set at ≤0.05.<strong></strong></p><p><strong>Results: </strong>The mean age of the study participants was 33.36±8.31 years. The mean serum homocysteine, folate and VitB12 levels among the study participants were 5.59±9.14 nmol/l, 21.57±4.15ng/ml and 1694.38±592.83 pg/ml respectively. About 8% of the study participants had serum homocysteine levels more than 15nmol/L, 4% had vitamin B12 levels less than 203pg/ml while all 100 participants had normal folate levels of 4ng/ml and above.</p><p><strong>Conclusions:</strong> The prevalence of hyperhomocysteinemia, vitaminB12 and folate deficiencies among blood donors in LASUTH is low.</p>

Association of Hypertension with Raised Serum Homocysteine Levels

Objective: To study the association of hypertension with raised serum homocysteine levels.
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Army Medical College Rawalpindi in collaboration with Armed Forces Institute of Pathology and Military Hospital Rawalpindi, from Mar to May 2021.
 Methodology: Total study participants were four hundred in number. Two hundred patients with hypertension aged between 35-55 years were included in Group-1, whereas two hundred non-hypertensive patients with the closest possible age and sex matching were included in Group-2. Strict adherence to inclusion and exclusion criteria was ensured.
 Results: The mean age of patients with hypertension (Group 1) was 42.60 ± 9.95 years, and without hypertension, i.e., healthy participants (Group 2), was 42.26 ± 10.03 years. Systolic BP was 157.92 ± 8.07 mmHg among Group 1 (hypertensive subjects) and 114.60 ± 4.58 mmHg among Group 2 (healthy participants). Mean diastolic blood pressure in patients with hypertension (Group 1) was 104.95 ± 5.87 mmHg, whereas it was 74.20 ± 4.74 mmHg among non-hypertensive healthy participants (Group 2). Mean serum homocysteine level was significantly correlated with hypertension (p-value <0.001, r=0.804 for systolic and p-value <0.001, r=0.792 for diastolic blood pressure) and was higher in Group 1(20.64 ± 4.40 µmol/L) than that of healthy Group 2(9.48 ± 2.38 µmol/L).
 Conclusion: Our study concludes that serum homocysteine had a significant positive correlation with hypertension and can be used as an early marker for hypertension assessment in addition to regular blood pressure measurements.

Elevated homocysteine and crises state in patients with sickle cell anemia

Background: High plasma concentration of homocysteine (Hcy) is a well-established risk factor for several disorders, including cardiovascular disease, stroke, venous thrombosis, and arteriosclerosis. Folic acid deficiency leads to an increase in homocysteine. This study aimed to test whether elevated serum homocysteine, diminished folate, and B12 levels correlate with the frequency of crisis in sickle cell disease (SCD). Methods: This was a comparative cross-sectional study conducted on 110 adults consisting of participants with SCD in vaso-occlusive crises (VOC), SCD in hyperhemolytic crises (HHC), SCD in steady-state (SS), and healthy controls. Serum homocysteine, folate, and B12 levels were determined using the Enzyme-linked immunosorbent assay method. The level of statistical significance was defined as P < 0.05, at a 95% confidence interval. Results: The mean age of all participants was 25.5 ± 5.8 years. There was a statistically significant difference in mean serum homocysteine levels with mean levels of (11.9 ± 4.5, 13.1 ± 5.4, 10.3 ± 2.3, 9.9 ± 2.5 μmol/L) in participants in VOC, HHC, SS, and controls, respectively (P = 0.016). With a cut-off of <15 μmol/L, hyperhomocysteinemia was seen in 31.% and 26.7% of participants in HHC and VOC, respectively. Conversely, no participant in the SS or the control group had hyperhomocysteinemia. Serum folate (nmol/L) level was lower, though not significantly, in the HHC group than in the other groups, with 9.9 ± 5.5 versus 12.7 ± 6.8, 11.8 ± 4.1 and 12.7 ± 2.2 nmol/L for the VOC, SS, and control group, respectively (P = 0.121). A significant inverse correlation was found between homocysteine and folate (correlation coefficient − 0.589 and P < 0.001) in all study participants. Conclusion: This study reveals significantly higher homocysteine levels in participants with sickle anemia in vaso-occlusive and hyperhemolytic crises (HHCs), highlighting homocysteine and folate role in the pathogenesis of these events.

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

Homocysteine levels in implant failure patients: an observational study

Background: Dental implants have been a part of our lives since 1965 when studies of Branemark commenced. Today, ever increasing number of dental implants in total or partial edentulous patients provides an outstanding treatment alternative to conventional prosthetic rehabilitation all around the world. However, widespread use of dental implants has brought alone a gradually increasing condition called “disease of peri-implant tissues”. The present study was conducted for assessing the Homocysteine levels in implant failure patients. Materials & methods: A total of 25 subjects with clinical and radiographic evidence of peri-implantitis and 25 healthy controls were enrolled. Complete demographic and clinical details of all the subjects were obtained. Fasting (minimum of 12hrs) venous blood samples were collected. The venous blood was collected in plain vials which will sent to the laboratory for biochemical analysis and evaluation of systemic parameters of both peri-implantitis group and control group. Serum homocysteine was assessed by means of Elisa Immunoassay. Results: Mean serum homocysteine levels among subjects of the control group and peri-implantitis group was 13.27 µmol/L and 25.2 µmol/L respectively. Significant results were obtained while comparing the mean serum homocysteine levels among subjects of the peri-implantitis group and control group.

Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients

Background/purpose: Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients. Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively. ResultsWe found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients. ConclusionThe younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients.

Significantly higher frequencies of macrocytosis, anemia, serum vitamin B12 and folic acid deficiencies, and hyperhomocysteinemia in male than in female atrophic glossitis patients

Background/purposeOur previous study found that 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 150 male and 914 female AG patients. Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 150 male and 914 female AG patients were measured and compared with the corresponding levels in 75 male and 457 female healthy control subjects (HCSs), respectively. ResultsWe found that 150 male AG patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels, and significantly higher mean serum homocysteine levels than 75 male HCSs. Moreover, 914 female AG patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 457 female HCSs. In addition, 150 male AG patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiency and hyperhomocysteinemia than 914 female AG patients. ConclusionThe male AG patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than the female AG patients.

Relationship of lung function with homocysteine, vitamin B12 and folic acid level in metabolic syndrome

Background: Metabolic syndrome (MetS) is a complex metabolic disorder and with debilitating effects on many organs including lung function impairment. Hyperhomocysteinaemia is caused by nutritional deficiency of vitamin B12 and folic acid can increase this risk further. Both the metabolic syndrome and hyperhomocysteinaemia adversely affect the lung function. But no study was found in Bangladeshi MetS in this regard. Objective: To assess the relationship of lung function with serum homocysteine, vitamin B12 and folic acid level in metabolic syndrome. Methods: This cross-sectional study was conducted in the department of physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from November, 2019 to April, 2020. A total of 60 female subjects were selected with the age ranging from 25-45 year by purposive sampling. Among them 30 metabolic syndrome patients were included in the study group (group A) and 30 age and sex matched apparently healthy subjects constituted comparison group (group B). Serum homocysteine, vitamin B12, folic acid and other biochemical parameters and the lung function of all subjects were assessed. Data were expressed as mean±SD. Spirometric measures were expressed as percent of predicted value. Statistical analysis was done by Independent sample ‘t’ test and Pearson’s correlation coefficient test. Results: In this study, the mean percentage of predicted value of FVC, FEV1 and, PEFR were significantly lower (p<0.001) in group A than those of group B. The mean serum homocysteine level was higher and vitamin B12 and folic acid level were lower in metabolic syndrome patients compared to comparison group and the difference was statistically significant only for homocysteine (p<0.05). In addition, the FVC and FEV1 were significantly negatively correlated (p<0.05) with serum homocysteine and FVC was significantly positively correlated (p<0.05) with serum folic acid level in group A. Conclusion: The present study reveals that impairment of lung function is related to higher level of homocysteine and lower level of folic acid in metabolic syndrome. Bangladesh Med Res Counc Bull 2021; 47(2): 175-180

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.

Cerebral Venous Sinus Thrombosis (CVST) as a Complication of SARS-COV2 Infection

Background and Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection induces a prothrombotic state frequently associated with arterial ischemic strokes. Cerebral venous sinus thrombosis (CVST) is also reported with corona virus disease-19 (COVID-19) but a large cohort study is lacking. Our aim was to study the characteristics, treatment response, and outcomes of CVST occurring in association with COVID-19 (COVID-CVST) and the causal relationship with COVID-19. Methods: Data of 34 patients admitted in COVID facility and suffering from CVST and SARS-COV2 infection was studied with respect to their clinic-radiological and lab features, predisposing factors, treatment, and outcome. Observations and Results: 15 patients with CVST were detected positive for COVID but remained asymptomatic for the same. 14 patients had CVST along with symptoms of COVID, whereas 5 had CVST after recovery from COVID, at an average of 18 days after COVID-19. 4 patients were on aspirin as prophylaxis against thrombo-embolic events. The number of males exceeded females (22:12), conventional risk factors were seen in only 8 patients (postpartum state-3, alcohol abuse-2 and anemia-3), whereas the majority (26/34) showed none of them. The mean serum homocysteine level was normal and antiphospholipid antibody was tested normal in the assessed subjects. D-dimer and C reactive protein were elevated in all. 4 symptomatic patients who suffered from severe pneumonia died because of systemic complications. Conclusion: COVID-19 predisposes to CVST and the outcome is related to the severity of COVID pneumonia. CVST related to COVID occurs during or after a few weeks of COVID pneumonia and can also be seen in asymptomatic SARS-COV2 infection. COVID-19 can occur independently or in association with traditional thrombotic risk factors which increase the risk and severity of CVST in COVID. If recognized early, CVST associated with COVID can usually be treated effectively to achieve a very good outcome.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in younger and older burning mouth syndrome patients

Background/purposeOur previous study found that 19.8%, 16.2%, 4.8%, 2.3%, and 19.2% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 272 younger (≤50 years old) and 612 older (>50 years old) BMS patients.Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 272 younger and 612 older BMS patients were measured and compared with the corresponding levels in 136 younger (≤50 years old) and 306 older (>50 years old) healthy control subjects (HCSs), respectively.ResultsWe found that 272 younger BMS patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels than 136 younger HCSs. Moreover, 612 older BMS patients had significantly lower mean blood Hb, and serum iron and vitamin B12 levels and significantly higher mean serum homocysteine level than 306 older HCSs. In addition, 272 younger BMS patients had higher mean blood Hb level (marginal significance, P = 0.056), significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of iron and folic acid deficiencies than 612 older BMS patients.ConclusionThe younger BMS patients do have higher mean blood Hb level, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of serum iron and folic acid deficiencies than the older BMS patients.

Analysis on Value of Applying Serum miR-144 and miR-221 Levels in Diagnosing Atherosclerosis.

Objective To explore the value of serum miR-144 and miR-221 in diagnosing atherosclerosis (AS). Methods The clinical data of 52 AS patients treated in the department of cardiovascular medicine of our hospital from August 2019 to August 2020 were retrospectively analyzed, and 53 healthy persons were selected from the physical examination center at the same period as the control group. By measuring the indicators including the serum vascular endothelial growth factor (VEGF), superoxide dismutase (SOD), miR-144, and miR-221 in patients of both groups, their value of diagnosing AS was analyzed. Results Compared with the control group, the AS group obtained significantly higher serum miR-221 and miR-144 expression levels (P < 0.001), significantly higher mean serum homocysteine (Hcy) level value (P < 0.001), lower mean serum SOD level (P < 0.001), and significantly higher level values of serum VEGF, nuclear factor-kappaB (NF-kB), and transforming growth factor-β (TGF-β) (P < 0.001), and the area under ROC curve, sensitivity, and specificity of combining miR-221 with miR-144 were significantly higher than those of single diagnosis. Conclusion Serum miR-221 and miR-144 expression levels are increased in AS patients, and combining the two indicators in diagnosis is more accurate and can provide an accurate basis for diagnosis and condition assessment of AS.