Mean Serum Homocysteine Research Articles

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

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

Anemia, hematinic deficiencies, and hyperhomocysteinemia in male and female burning mouth syndrome patients

Background/purposeOur previous study found that 19.8%, 16.2%, 4.8%, 2.3%, 19.2%, and 12.3% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 212 male and 672 female BMS patients. Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 212 male and 672 female BMS patients were measured and compared with the corresponding levels in 106 male and 336 female healthy control subjects, respectively. ResultsWe found that 212 male BMS patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels and significantly higher mean serum homocysteine levels than 106 male healthy control subjects. Moreover, 672 female BMS patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 336 female healthy control subjects. In addition, 212 male BMS 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 folic acid deficiency and hyperhomocysteinemis than 672 female BMS patients. ConclusionThe male BMS 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 folic acid deficiency and hyperhomocysteinemis than the female BMS patients.

Nitrous oxide-induced myeloneuropathy.

Nitrous oxide misuse is a recognized issue worldwide. Prolonged misuse inactivates vitamin B12, causing a myeloneuropathy. Twenty patients presenting between 2016 and 2020 to tertiary hospitals in Sydney with myeloneuropathy due to nitrous oxide misuse were reviewed. The average age was 24years, and mean canister consumption was 148 per day for 9months. At presentation, paresthesias and gait unsteadiness were common, and seven patients were bedbound. Mean serum B12 was normal (258pmol/L, normal range [NR]=140-750) as was active B12 (87pmol/L, normal>35). In contrast, mean serum homocysteine was high (51μmol/L, NR=5-15). Spinal magnetic resonance imaging (MRI) showed characteristic dorsal column T2 hyperintensities in all 20 patients. Nerve conduction studies showed a predominantly axonal sensorimotor neuropathy (n=5). Patients were treated with intramuscular vitamin B12, with variable functional recovery. Three of the seven patients who were bedbound at presentation were able to walk again with an aid at discharge. Of eight patients with follow-up data, most had persistent paresthesias and/or sensory ataxia. Mobility scores at admission and discharge were not significantly correlated with the serum total and active B12 levels or cumulative nitrous oxide use. There were no significant trends between serum active B12 level and cumulative nitrous oxide use (Spearman rho = -0.331, p=0.195). Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients.

Association of Maternal Serum Homocysteine Levels with Pre-eclampsia

Background: Pre-eclampsia is a major cause of maternal or fetal morbidity and mortality. Its pathophysiology is still an area of dilemma. Homocysteine is a sulfur containing amino acid, which damages smooth muscle of the vessel wall. The objective of this study was to investigate the association of serum homocysteine levels with preeclampsia.
 Materials and methods: This case control study was carried out in the Department of Obstetrics & Gynecology Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from April 2017 to March 2018. The study reviewed a total of 108 women with pregnancy. These participants were categorized into three groups: healthy pregnant subjects group, mild preeclampsia group and severe preeclampsia group. The three study groups were statistically similar in aspects of maternal age, gestational age and parity.
 Results: The mean serum homocysteine level was found 16.4±7.9 μmol/l in mild preeclampsia group, 20.8±8.0 μmol/l in severe preeclampsia group and 8.2±3.7 μmol/l in the group of normal pregnant women. Serum homocysteine was significantly increased in severe preeclampsia and mild preeclampsia in comparison to normal group without preeclampsia. Significant positive correlation was found between systolic blood pressure (p=0.001) diastolic blood pressure (p=0.001) with serum homocysteine level.
 Conclusion: The study concluded that a significant positive association was found between pre-eclampsia and maternal serum homocysteine levels. This may provide informationonthe role of homocysteine in preeclampsia with a preventive strategy of consequences of this condition.
 JCMCTA 2021 ; 32 (1) : 14-20

Study on Homocysteinemia as a Risk Factor of Ischemic Stroke

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

Higher serum homocysteine level and frequency of hyperhomocysteinemia in carcinoembryonic antigen-positive or squamous cell carcinoma-antigen-positive oral leukoplakia patients

Our previous study found significantly lower serum hematinic levels and higher serum homocysteine level as well as higher frequencies of serum hematinic deficiencies and hyperhomocysteinemia in oral leukoplakia (OL) patients than in healthy control subjects. This study evaluated whether carcinoembryonic antigen (CEA)-positive or squamous cell carcinoma-antigen (SCC-Ag)-positive OL patients had significantly lower serum hematinic levels and higher serum homocysteine level as well as significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients or healthy control subjects. The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 184 OL patients including 85 CEA-positive, 99 CEA-negative, 25 SCC-Ag-positive, and 159 SCC-Ag-negative OL patients and in 184 age- and sex-matched healthy control subjects were measured and compared. We found that the 85 CEA-positive or 25 SCC-Ag-positive OL patients had a significantly lower mean serum folic acid level and a significantly higher mean serum homocysteine level as well as significantly higher frequencies of serum folic acid deficiency and hyperhomocysteinemia than 184 healthy control subjects. Moreover, the 25 SCC-Ag-positive OL patients had a significantly higher mean serum homocysteine level than the 159 SCC-Ag-negative OL patients. The 85 CEA-positive OL patients had a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than 99 CEA-negative OL patients (marginally significant, P=0.060). CEA-positive or SCC-Ag-positive OL patients tend to have a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients, respectively.

Association of Hyperhomocysteinemia with Early Onset Atherosclerotic Peripheral Arterial Occlusive Diseases

Background: Homocysteine is increasingly recognized as an independent risk factor for vascular disease specially peripheral arterial occlusive diseases. In the present study, an attempt was made to find out the association between the raised fasting plasma total homocysteine level and early onset atherosclerotic peripheral arterial occlusive diseases (PAOD).
 Methods: In this prospective observational study a total of 50 study subjects were included. All patients were clinically and angiographically documented for atherosclerotic PAOD. All patients underwent surgical intervention as well as estimation of serum total homocysteine level. Arterial segment was sent for histopathological examination to find out whether atherosclerosis was present or not. Patients were divided into two groups- Group-1 included patients of 20-40 years of age and group-II included those of 41-60 years of age. The groups were compared to see association between elevated level of plasma homocysteine and atherosclerotic peripheral arterial occlusive diseases in elderly as well as in early age.
 Results: 41 (82%) patients were male and 9 (18%) patients were female. Serum homocysteine level was higher in group I than group II (71.4% vs. 40.9%). Besides, the level of mean serum homocysteine level was significantly (p=0.02) higher in group I than group II (21.18±9.53 vs. 17.24±8.92 μmol/L).
 Conclusion: In conclusion, this study suggests that serum homocysteine has an association with early onset atherosclerotic PAOD. Therefore, a raised serum homocysteine level can be used as an independent biochemical predictor of early onset atherosclerotic PAOD.
 Cardiovasc. j. 2021; 13(2): 120-127

Association of serum homocysteine levels with the development of preeclampsia

Aims: To determine the association between serum homocysteine levels and preeclampsia and its relevance as a potential marker for predicting preeclampsia.
 Methods: A total number of 50 preeclampsia cases were taken. 30 cases of normal pregnancy were taken as controls. This study was carried out in the Department of Obstetrics and Gynecology, Gauhati Medical College and Hospital, Gauahati from August 2012 to July 2013. Blood samples were drawn from the antecubital vein and serum homocysteine levels were measured.
 Results: The mean serum homocysteine levels in preeclampsia cases were 27.7 ± 6.4 μmol/l compared to serum homocysteine levels in normal pregnancy 9.23 ± 3.4 μmol/l (P<0.01).There was a significant relationship between the systolic and the diastolic blood pressure and serum homocysteine levels. As the systolic and diastolic blood pressure increases, serum homocysteine levels also increased significantly (P<0.001).
 Conclusion: This study showed raised serum homocysteine levels in patients with preeclampsia compared to normal pregnancy.
 Keywords: Serum homocysteine; Preeclampsia; Blood pressure

Cut-off value of serum homocysteine in relation to increase of coronary artery calcification

A recent study reported that coronary artery calcification (CAC) and serum homocysteine were well associated; however, no report is available for the cut-off value of serum homocysteine according to increase...

Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative burning mouth syndrome patients

Our previous study found the serum gastric parietal cell antibody (GPCA) positivity in 12.3% of burning mouth syndrome (BMS) patients. This study assessed whether GPCA-positive BMS (GPCA+BMS) patients had significantly higher frequencies of macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects or GPCA-negative BMS (GPCA-BMS) patients. The mean corpuscular volume, blood hemoglobin (Hb), and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels were measured and compared between any two of three groups of 109 GPCA+BMS patients, 775 GPCA-BMS patients, and 442 healthy control subjects. We found that 109 GPCA+BMS patients had significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values<0.001) and significantly higher frequencies of macrocytosis, blood Hb and serum vitamin B12 deficiencies, and hyperhomocysteinemia than 775 GPCA-BMS patients (all P-values<0.01). Moreover, 775 GPCA-BMS patients had significantly higher frequencies of macrocytosis, blood Hb and serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values<0.005). Pernicious anemia (45.5%) and normocytic anemia (24.2%) were the two most common types of anemia in 33 anemic GPCA+BMS patients. Moreover, normocytic anemia (61.3%), thalassemia trait-induced anemia (15.5%), and iron deficiency anemia (14.1%) were the three most common types of anemia in 142 anemic GPCA-BMS patients. GPCA+BMS patients have significantly higher frequencies of macrocytosis, blood Hb and serum vitamin B12 deficiencies, and hyperhomocysteinemia than healthy control subjects or GPCA-BMS patients.

Schistocytosis in megaloblastic anemia masquerading peripheral blood picture as maha (microangiopathic hemolytic anemia) and decrease mean corpuscular volume

Severe megaloblastic anemia presenting with hemolytic anemia, thrombocytopenia and schistocytosis resemble microangiopathic hemolytic anemia. Presence of scistocytes falsely decreases the Mean corpuscular volume. Toestimate the degree of schistocytosis in megaloblastic anemia with hemolytic blood picture and its correlation with the lowering of MCV. 60 cases of megaloblastic anemia.30 patients of megaloblastic anemia with hemolysis(cases) and 30 patients without hemolysis(clinical control)were taken. Complete blood count, Peripheral smear examination, schistocyte count, serum bilirubin, LDH, Homocystine was done. Mean age of clinical control group was 22 where as that of cases was 14.1 years. Mean serum homocysteine level was increased in both clinical control group and cases. In our study of 30 megaloblastic anemia patients with hemolysis (case), 29 had &amp;#62;1% of schistocytes in their peripheral blood picture. There is a positive correlation between percentage of schistocytes and homocysteine and a negative correlation between MCV and homocysteine. There is a statistically significant negative correlation existing between percentage of schistocytes and MCV.Presence of scistocytes in peripheral blood should not be always considered as MAHA, and lowering of MCV should not be confused as microcytic hypochromic anemia. Presence of macroovalocytes and hypersegmented neutrophils can be a clue for diagnosis of megaloblastic anemia with hemolysis in such type of cases.

Prospective study of relationship between deep vein thrombosis and homocysteine related group B vitamins

Introduction: Hyper homocysteinemia has been considered as a potential risk factor for deep venous thrombosis (DVT) but it is still controversy. This study was aimed to assess the prevalence of hyper homocysteinemia in our population with DVT. Our second objective was to document the prevalence of folate, Vitamin B6, and Vitamin B12 level in this patient population. Results: Mean serum homocysteine levels among DVT patients was 15.12±5.47 μmol/L. Most of the patients of DVT were from 41-60 years of age group with mean age being 50.11±13.66 years. Of all the patients, 15 patients had homocysteine level above the 15 µmol/L, 22 had folic acid level below 3 ng/ml, 14 had vitamin B12 level below 150 pmol/L, and 3 had vitamin B6 level below 30 nmol/L. In the hyper homocysteinemic group, eleven patients had low folic acid level, ten had low vitamin B12 level and two had low vitamin B6 level.Conclusions: Hyper homocysteinemia and related Vitamin B group deficiency are risk factors for Deep vein thrombosis. Hyper homocysteinemia and risk of DVT, this correlation is high among older age group and female patients.

Association of MTHFR C677T polymorphism with elevated homocysteine level and disease development in vitiligo.

Increasing evidence on the association of MTHFR gene polymorphism and serum homocysteine levels with autoimmune diseases such as vitiligo has made the MTHFR gene a very interesting candidate to be evaluated in different ethnicities and populations. We aimed to evaluate the levels of serum homocysteine and vitamin B12 and their associations with MTHFR C677T polymorphism in the Iranian population. This case-control study included 104 patients with vitiligo and 100 age- and sex-matched healthy control subjects. Serum vitamin B12 and homocysteine levels were measured by a chemiluminescence assay. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was used for genotyping the polymorphism. The mean serum homocysteine levels were significantly higher in cases than controls and associated with disease activity (p<.001). Furthermore, the homozygous MTHFR C677T variant genotype was associated with vitiligo development (adjusted OR: 3.52, 95% CI: 1.09-11.32, p=.02) and elevated homocysteine level (p<.001). There was no association between serum vitamin B12 levels and the MTHFR C677T genotype. The homozygous variant MTHFR C677T may be considered as a risk factor for both elevated homocysteine levels and the development of vitiligo in the Iranian population. Although these results are not conclusive, they could elucidate the contribution of genetic and immune-mediated inflammatory factors to the pathogenesis of vitiligo.

Lipid Risk Factors in Vitiligo: Homocysteine the Connecting Link?

Vitiligo is an acquired, depigmenting skin disease with unclear, multifactorial etiopathogenesis affecting not only skin but also connected with metabolic abnormalities, including glucose and lipid abnormalities, confirming the systemic nature of the disease. Vitamin B12 and folic acid deficiencies have also been implicated in vitiligo that can lead to increased homocysteine levels in the circulation, a finding that can be expected in vitiligo. Further, an association between hyperlipidemia and hyperhomocysteinemia has been suggested in vitiligo patients showing the eminent need of management of vascular risk factors especially in diseases with metabolic abnormalities. The present study was thus aimed to assess homocysteine levels and lipid risk factors in vitiligo patients and to study their interrelationship to predict the cardiometabolic risk in vitiligo and its management. The present cross-sectional study included 54 case of generalized vitiligo and 54 age and gender-matched healthy adults as controls. Patients were assessed for disease activity and severity (VASI Score). All the subjects were evaluated for the lipid profile and serum homocysteine levels. Lipid profile analysis showed significantly higher LDL-cholesterol concentration (p = 0.010), significantly lower HDL-cholesterol concentration (p = 0.003) and significantly higher LDL/HDL ratio (p = 0.001) in patients with vitiligo in comparison with the control group. The mean serum homocysteine levels in vitiligo patients (18.76 ± 10.02 µmol/L) were significantly higher than in controls (10.04 ± 5.34 μmol/L) (p = 0.000). Serum homocysteine levels showed a positive correlation with the duration of disease which was near to significant (p = 0.064) and VASI score (p = 0.000). No significant correlation was observed between serum Hcy levels and lipid profile. The present study showed significantly higher Hcy levels in vitiligo patients than controls which may be a precipitating factor in the pathogenesis of vitiligo in predisposed individuals. The results of our study are also indicative of lipid disturbances in vitiligo. These findings may reflect some ongoing abnormal metabolic processes in patients with vitiligo. Therefore, we recommend routine estimation of homocysteine and lipid profile in vitiligo patients both of which should be regarded as independent significant contributing factors of cardiometabolic risk worth considering in the management of patients with vitiligo.

Serum homocysteine concentration in dogs with immunosuppressant-responsive enteropathy.

BackgroundHomocysteine (HCY) was evaluated in healthy and chronic enteropathic dogs, however no studies on dogs with immunosuppressant-responsive enteropathy are available.ObjectivesThe aim was to evaluate serum HCY concentrations and its prognostic role in dogs with immunosuppressant-responsive enteropathy compared to healthy dogs.MethodsSerum HCY concentration was statistically compared between 24 healthy dogs and 29 dogs with immunosuppressant-responsive enteropathy. Correlation analyses between serum total protein, albumin (ALB), C-reactive protein (CRP), folate and cobalamin, and serum HCY concentration were performed in immunosuppressant-responsive enteropathic dogs.ResultsThe associations between serum HCY concentration and clinical, histological, endoscopic scores and follow-up were evaluated. Mean serum HCY concentration was higher in immunosuppressant-responsive enteropathic dogs compared to control dogs (30.22 ± 8.67 µmol/L vs. 5.26 ± 2.78 µmol/L; p < 0.0001). No association between serum HCY concentration and total protein, ALB, CRP, folate concentration as well as, clinical score, histological and endoscopic scores was found. A negative correlation between serum HCY concentration and cobalamin was noted (p = 0.0025, r = −0.54). No significant difference in HCY was found between responsive and non-responsive dogs or between survivors and non-survivors.ConclusionsAlthough, serum HCY concentration was higher in immunosuppressant-responsive enteropathy, its prognostic value remains unclear. However, further prospective, large-scale studies are warranted to better investigate the possible prognostic role of HCY in immunosuppressant-responsive enteropathic dogs.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with vitamin B12 deficiency

Background/purposeOur previous study found that 42 of 884 burning mouth syndrome (BMS) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient BMS (B12D/BMS) patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects and evaluated whether all B12D/BMS patients had pernicious anemia (PA). Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 42 B12D/BMS patients and 442 healthy control subjects were measured and compared. ResultsWe found that 42 B12D/BMS patients had significantly lower mean blood Hb and serum iron and vitamin B12 levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 42 B12D/BMS patients had significantly higher frequencies of macrocytosis (52.4%), blood Hb (61.9%) and serum iron (26.2%) and vitamin B12 (100.0%) deficiencies, hyperhomocysteinemia (83.3%), and serum GPCA positivity (42.9%) than 442 healthy control subjects (all P-values < 0.001). Moreover, of 26 anemic B12D/BMS patients, 15 (57.7%) had PA, 5 (19.2%) had macrocytic anemia other than PA, 4 (15.4%) had normocytic anemia, and 2 (7.7%) had thalassemia trait-induced anemia. ConclusionB12D/BMS patients have significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Although PA is the most common type of anemia in our B12D/BMS patients, only 15 (35.7%) of 42 B12D/BMS patients have PA.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with iron deficiency

Background/purposeOur previous study found that 143 of 884 burning mouth syndrome (BMS) patients have iron deficiency (ID). This study assessed whether all BMS patients with ID (so-called ID/BMS patients) had iron deficiency anemia (IDA) and evaluated whether the ID/BMS patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects.Materials and methodsThe blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 143 ID/BMS patients and 442 healthy control subjects were measured and compared.ResultsWe found that 143 ID/BMS patients had significantly lower mean blood Hb and serum iron, vitamin B12, folic acid levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values < 0.01). Moreover, 143 ID/BMS patients had significantly higher frequencies of blood Hb (55.9%) and serum iron (100.0%), vitamin B12 (7.7%), and folic acid (2.1%) deficiencies, hyperhomocysteinemia (27.3%), and serum GPCA positivity (12.6%) than 442 healthy control subjects (all P-values < 0.001). Furthermore, of 80 anemic ID/BMS patients, 5 (6.3%) had pernicious anemia, 5 (6.3%) had macrocytic anemia other than pernicious anemia, 42 (52.5%) had normocytic anemia, 21 (26.3%) had IDA, and 7 (8.8%) had thalassemia trait-induced anemia.ConclusionID/BMS patients had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Normocytic anemia is the most common type of anemia in ID/BMS patients.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with vitamin B12 deficiency

Our previous study found that 56 of 1064 atrophic glossitis (AG) patients have vitamin B12 deficiency. This study assessed whether the AG patients with vitamin B12 deficiency (B12D/AG patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 56 B12D/AG patients and 532 healthy control subjects were measured and compared. We found that 56 B12D/AG patients had significantly lower mean blood Hb and serum iron levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values<0.05). Moreover, 56 B12D/AG patients had significantly higher frequencies of macrocytosis (53.6%), blood Hb (64.3%), iron (26.8%), and folic acid (3.6%) deficiencies, hyperhomocysteinemia (89.3%), and serum GPCA positivity (55.4%) than 532 healthy control subjects (all P-values<0.005). In addition, of 36 anemic B12D/AG patients, 22 (61.1%) had pernicious anemia (PA), 6 (16.7%) had macrocytic anemia other than PA, 4 (11.1%) had normocytic anemia, 3 (8.3%) had iron deficiency anemia (IDA), and one (2.8%) had microcytic anemia other than IDA and thalassemia trait-induced anemia. We conclude that B12D/AG patients have significantly higher frequencies of macrocytosis, blood Hb, iron, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. PA is the most common type of anemia in our B12D/AG patients.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with iron deficiency

Our previous study found that 180 of 1064 atrophic glossitis (AG) patients have iron deficiency. This study assessed whether all AG patients with iron deficiency (so-called ID/AG patients) had iron deficiency anemia (IDA) and evaluated whether the ID/AG patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 180 ID/AG patients and 532 healthy control subjects were measured and compared. We found that 180 ID/AG patients had significantly lower mean corpuscular volume (MCV) and lower mean blood Hb and serum iron levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values<0.001). Moreover, 180 ID/AG patients had significantly higher frequencies of blood Hb (46.1%), serum iron (100.0%), vitamin B12 (8.3%), and folic acid (4.4%) deficiencies, hyperhomocysteinemia (16.1%), and serum GPCA positivity (31.1%) than 532 healthy control subjects (all P-values<0.001). In addition, of 83 anemic ID/AG patients, 9 (10.8%) had pernicious anemia, 40 (48.2%) had normocytic anemia, 30 (36.2%) had IDA, and 4 (4.8%) had thalassemia trait-induced anemia. We conclude that ID/AG patients had significantly higher frequencies of blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects. Normocytic anemia is the most common type of anemia in ID/AG patients, followed by IDA, pernicious anemia, and thalassemia trait-induced anemia.

Hyperhomocysteinemia and increased risk of coronary artery disease in Iranian patients with diabetes mellitus type II: a cross-sectional study

Hyperhomocysteinemia in patients with diabetes mellitus (DM) has been proposed as a new risk factor for coronary artery disease (CAD). Due to the prevalence of DM and CAD in the Iranian population and the relatively high economic burden, research on these new risk factors sounds necessary. This study investigated the relationship between hyperhomocysteinemia and coronary heart disease in patients with type 2 diabetes. This study was a hospital-based cross-sectional study performed on 100 diabetic patients with indications of coronary artery angiography. After the measurement of serum HbA1c and homocysteine, the patients went through coronary angiography and, based on the results, were divided into two groups of normal and obstructed coronary arteries. Serum homocysteine and other related risk factors were further compared between the two groups. The mean serum homocysteine of patients was 13.18 ± 3.64 I¼mol/L in general and 15.02 ± 3.7 I¼mol/L in those with coronary artery obstruction. With hyperhomocysteinemia defined as serum homocysteine of â�¥ 14 I¼mol/L, 48 of diabetic patients had hyperhomocysteinemia, of which 83 had coronary artery obstruction. The relationship between serum homocysteine and coronary artery obstruction was significant (P < 0.001). The serum homocysteine was the highest in patients with three-vessel involvement (15.39 ± 3.5 I¼mol/L), which was significantly higher than those with normal coronary arteries (P < 0.001). The mean serum homocysteine of diabetic patients (type II) with coronary artery disease was significantly higher than those with normal coronary arteries. It was also significantly higher in patients with three-vessel involvement than those with no vessel involvement. © 2019, Springer-Verlag London Ltd., part of Springer Nature.