Plasma Hcy Levels In Patients Research Articles

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

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

Association between high BMI and high homocysteine levels in Chinese patients with bipolar disorder

BackgroundBipolar disorder (BD) has been associated with an increased prevalence of weight gain and abnormally elevated plasma homocysteine (Hcy) levels. However, the relationship between BMI and Hcy in BD patients has not been investigated. This study aimed to explore this relationship in Chinese patients with BD. MethodsPlasma Hcy levels, socio-demographic parameters, clinical and anthropometric data were collected from 195 BD inpatients and 84 healthy controls. The level of plasma Hcy was determined by high-performance liquid chromatography. Body mass index (BMI) was calculated by body weight divided by the square of the height. The participants were divided into a high BMI group and a low BMI group using 24 kg/m2 as a threshold. ResultsThe prevalence of high BMI was slightly elevated in BD patients in comparison to healthy controls. Patients with elevated BMI had significantly higher Hcy levels than patients with low BMI. Hcy level was an independent contributor of the occurrence of high BMI in BD patients. The level of Hcy was positively correlated with BMI in BD patients. In addition, depressive episodes of BD were positively correlated with the prevalence of high BMI and married BD patients were more likely to have high BMI levels. ConclusionsThere is a close relationship between BMI and plasma Hcy levels in patients with BD, suggesting that Hcy may be an important indicator for BD-induced weight gain. This finding provides a new avenue for weight management of BD patients and to help avoid the potential risk of cardiovascular diseases.

Impaired coronary blood flow may be related to elevated homocysteine levels in patients with metabolic syndrome.

Metabolic syndrome (MS) refers to a group of cardiovascular risk factors associated with endothelial dysfunction and impaired coronary blood flow (CBF). Homocysteine (Hcy) is another risk factor for the development of insulin resistance and endothelial dysfunction. However, the relationship between Hcy levels and CBF in patients with MS has not been investigated specifically. In the present study, we aimed to evaluate the relationship between Hcy levels and CBF in MS patients with normal coronary arteries. The study population included 36 patients with MS (20 males, 16 females; mean age = 55 ± 9 years) and 36 control subjects (20 males, 16 females; mean age = 51 ± 7 years). All subjects had angiographically proven normal coronary arteries. Plasma Hcy concentrations were evaluated after a fast of 12 h or longer. The CBF rates of all subjects were documented by the thrombolysis in myocardial infarction (TIMI) frame count method. The TIMI frame counts for each major epicardial coronary artery and mean TIMI frame count were found to be significantly higher in the MS group compared with the control group (left anterior descending coronary artery (LAD): 53 ± 26 vs. 39 ± 17; p = 0.01, left circumflex artery (LCx): 32 ± 12 vs. 26 ± 11; p = 0.01, right coronary artery (RCA): 33 ± 14 vs. 26 ± 12; p = 0.02, mean TIMI frame count: 39 ± 16 vs. 20 ± 12; p = 0.01). Plasma Hcy levels in patients with MS were significantly higher compared with controls (MS group = 11.6 ± 4 and control group = 9.6 ± 2.6; p = 0.01). Additionally, plasma Hcy levels were positively correlated with each calculated TIMI frame count value in the MS group (LAD, r: 0.28 and p = 0.006; LCx, r: 0.25 and p = 0.022; RCA, r: 0.26 and p = 0.042; mean TIMI frame count, r: 0.28 and p = 0.004). Plasma Hcy levels and TIMI frame counts were significantly higher in patients with MS. Impaired CBF in MS may be related to elevated levels of Hcy, even if Hcy levels are normal.

Plasma homocysteine, folic acid and vitamin B12 levels in patients with colon adenomatous polyps

Plasma levels of homocysteine (Hcy), folic acid (FA) and Vitamin B12 (VB12) were measured in 120 patients of colon adenomatous polyps and 40 healthy subjects. Plasma Hcy levels in colon adenomatous polyps patients were significantly higher than those in controls[(14.24 ± 0.52) μmol/L vs.(10.93±0.81) μmol/L, P=0.0014)], while plasma FA levels in polyps patients were lower than those in controls [(6.26±0.27) μg/L vs.(10.74±0.85) μg/L, P<0.0001]. There was no difference in plasma VB12 levels between two groups(P=0.7100). The plasma Hcy levels in patients with multiple colon polyps were higher than those with single colon polyps(P=0.0092), while the plasma FA levels demonstrated contrary results (P=0.0047). With the pathological type progression, the plasma Hcy levels were gradually raised, and FA levels gradually decreased. Plasma levels of FA, Hcy and VB12 were not correlated with the location and distribution of polyps. These results suggest that plasma FA and Hcy levels may be related to disease progress in patients with colon adenomatous polyps. Key words: Adenomatous polyposis Coli; Homocysteine

Elevated homocysteine levels in levodopa-treated idiopathic Parkinson's disease: a meta-analysis

To assess the association between the elevation of plasma homocysteine (Hcy) level and long-term levodopa (L-dopa) therapy in idiopathic Parkinson's disease (PD). We performed a systematic literature review to recruit original studies published up to May 14, 2012. Studies enrolled should be controlled, with specific information of long-term L-dopa application and plasma Hcy in patients with PD. Effects were summarized using standardized mean differences (SMDs) or weighted mean differences (WMDs). Our search enrolled 22 eligible studies. Plasma Hcy levels were significantly higher in L-dopa-treated patients than those in healthy controls [SMD 0.97; 95% confidence interval (CI) 0.80-1.14, P < 0.001], L-dopa-naïve patients with PD (SMD 0.99; 95% CI 0.54-1.44, P < 0.001), and untreated patients (SMD 0.52; 95% CI 0.18-0.86, P < 0.01). However, its levels in untreated patients with PD were not significantly higher than in healthy controls (SMD 0.24; 95% CI -0.03 to 0.51, P > 0.05). Patients with PD treated with L-dopa plus catechol-O-methyltransferase inhibitor (COMT-I) showed lower plasma Hcy concentrations compared with L-dopa-treated patients (WMD 4.62; 95% CI 2.89-6.35, P < 0.001). L-dopa treatment is associated with the increase in plasma Hcy level in patients with PD. COMT-I may attenuate L-dopa-induced elevation of Hcy level.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and high plasma homocysteine in chronic hepatitis C (CHC) infected patients from the Northeast of Brazil.

Background/AimHyperhomocysteinemia due to Methylenetetrahydrofolate Reductase (MTHFR) gene, in particular the C677T (Ala222Val) polymorphism were recently associated to steatosis and fibrosis. We analyzed the frequency of MTHFR gene in a cross-sectional study of patients affected by Chronic Hepatitis C (CHC) from Northeast of Brazil.MethodOne hundred seven-four untreated patients with CHC were genotyped for the C677T MTHFR. Genomic DNA was extracted from peripheral blood cells and the C677T MTHFR polymorphism was identified by PCR-RFLP. The homocysteine (Hcy) levels were determined by chemiluminescence method. All patients were negative for markers of Wilson's disease, hemochromatosis and autoimmune diseases and have current and past daily alcohol intake less than 100 g/week.ResultsAmong subjects infected with CHC genotype non-1 the frequency of MTHFR genotypes TT was 9.8% versus 4.4% genotype 1 (p = 0.01). Nevertheless, association was found between the MTHFR genotype TT × CT/CC polymorphism and the degree of steatosis and fibrosis in both hepatitis C genotype (p < 0.05). A significant difference was found on plasma Hcy levels in patients with steatosis regardless of HCV genotype (p = 0.03).ConclusionOur results indicate that plasma Hcy levels is highly prevalent in subjects with chronic hepatits C with steatosis regardless of HCV genotype and vitamin deficiency. The presence of genotype TT of MTHFR C677T polymorphism was more common in CHC genotype non-1 infected patient regardless of histopathological classification and genotype TT+CT frequencies were significant in the presence of fibrosis grade 1+2 and of steatosis in CHC infected patients from the northeast of Brazil regardless of HCV genotype. The genetic susceptibility of MTHFR C677T polymorphism should be confirmed in a large population.

Hyperhomocysteinemia in patients with stasis dermatitis and ulcer: A novel finding with important therapeutic implications

Background: Although homocysteine (Hcy) has profound effects concerning vascular lesions and thrombosis, it has not previously been investigated in patients with stasis dermatitis and ulcer. Objective: To evaluate plasma Hcy levels in patients with stasis dermatitis and ulcer. Methods: A total of 25 patients (17 male, eight female; mean age of 36 ± 5.97 years) with stasis dermatitis, 40 patients with stasis ulcer (27 male, 13 female; mean age of 38.5 ± 7.96 years) and 35 healthy control individuals (25 male, 10 female; mean age of 36.9 ± 6.49 years) were included in this study. Patients taking vitamin supplements or patients with folic acid or vitamin B12 deficiency, diabetes mellitus, chronic hepatitis, renal failure and chronic alcoholism which might affect Hcy levels were excluded from the study. Results: Hcy levels were found to be elevated in patients with stasis dermatitis (p = 0.00) and stasis ulcer (p = 0.00) compared to healthy controls with a median (range) of 19.1 µmol/l (15–28), 18.98 µmol/l (15–29), and 8.1 µmol/l (5–12.2), respectively. There was no statistically significant difference in Hcy level in patients with stasis dermatitis and ulcer (p = 0.877). Conclusion: As hyperhomocysteinemia can be treated by selected vitamin supplementation even in patients with normal serum vitamin concentrations, ulcer formation might be prevented by lowering Hcy in the clinical stage of stasis dermatitis.

Plasma homocysteine but not MTHFR gene polymorphism is associated with geriatric depression in the Chinese population.

Epidemiological studies suggested that elevated plasma homocysteine (Hcy) is associated with an increased risk of depression and cerebrovascular disease (CVD). There were few published reports of Hcy levels and methylenetetrahydrofolate reductase (MTHFR) C677T genotype in geriatric depression. To investigate the relationship among plasma Hcy level, MTHFR C677T polymorphism and geriatric depression in the Chinese population. The plasma Hcy level measured by capillary electrophoresis with ultraviolet detection and the C667T polymorphism of MTHFR detected using polymerase chain reaction-restriction fragment length polymorphism assay were determined in 116 patients with geriatric depression and in 80 healthy controls. The plasma Hcy level in the patients with geriatric depression was significantly higher than that in controls (p < 0.001). The age of first episode and comorbid CVD were significantly correlated with plasma Hcy levels in geriatric patients (p = 0.014 and 0.008, respectively). The Hamilton Rating Scale for Depression total score and plasma Hcy level at baseline showed no significant correlation in the patients (r = -0.111, p = 0.397). There were no significant differences in the MTHFR C677T polymorphism genotypes and alleles between the patients and the healthy controls (p = 0.654 and 0.573, respectively). The elevated plasma Hcy level is a risk factor for geriatric depression. MTHFR C667T genotype is not associated with geriatric depression in the Chinese population.

Serial measurements of plasma homocysteine levels in early and late phases of ischemic stroke

High plasma levels of homocysteine (Hcy) may predispose to ischemic stroke (IS), but results of previous studies have been conflicting. We decided to determine in IS patients whether their Hcy levels are elevated, whether levels vary at different time points following stroke, whether levels are associated with stroke severity, outcome, recurrence, etiology, infarct volume, or risk factors, and whether levels are correlated with hemostatic factors or C-reactive protein values. We measured plasma Hcy levels in 102 consecutive IS patients on admission and at 1 week, 1 month, and 3 months after stroke and once in 102 control subjects. Hemostatic factors were measured in 55 patients. Compared with controls, plasma Hcy levels in patients were significantly lower on admission but not at later time points, with levels increasing by week and remaining at this level for 3 months. Hcy levels showed a positive correlation with age and a negative correlation with Mini-Mental State Examination (MMSE) scores. Plasma Hcy levels inversely correlated with plasminogen activator inhibitor type-1. Decreased Hcy levels on admission may reflect the strength of the acute-phase response rather than a pathogenetic event. The negative correlation between Hcy levels and MMSE scores is more probably age-related than stroke-related.

The effect of entacapone on homocysteine levels in Parkinson disease

Elevated plasma homocysteine (Hcy) has been reported in patients with Parkinson disease (PD) treated with levodopa (LD) and is a risk factor for vascular disease and dementia.1 Plasma Hcy levels in patients with PD treated with LD are thought to be elevated by increased synthesis from the metabolism of LD by catechol-O-methyltransferase (COMT). An animal study has demonstrated that pretreatment with a COMT inhibitor can block the elevation of plasma Hcy levels when LD is given.2 These findings suggest that a COMT inhibitor, such as entacapone, may be able to block the elevation of plasma Hcy levels in patients with PD treated with LD. In the current study, we assessed the influence of entacapone on plasma Hcy levels in patients previously treated with LD alone. Subjects were selected from a group of patients participating in the Stalevo (carbidopa/levodopa/entacapone) Study (CELC200US02) designed to assess the tolerability of switching from LD to carbidopa/levodopa/entacapone. The study was …

Homocysteine levels in women with polycystic ovary syndrome treated with metformin versus rosiglitazone: a randomized study

Elevated levels of plasma homocysteine (Hcy) have been implicated as a significant risk factor for cardiovascular disease. Although long-term treatment with metformin can increase Hcy levels in patients with type II diabetes mellitus or coronary heart disease, it is becoming an increasingly accepted and widespread medication in polycystic ovary syndrome (PCOS). In the literature, only one study has demonstrated that metformin increases Hcy levels in PCOS patients, but the effect of other insulin sensitizers on Hcy levels have not been reported previously in women with PCOS. We aimed to assess the effects of metformin and rosiglitazone on plasma Hcy levels in patients with PCOS. Thirty women were randomized to two groups: 15 women in group 1 received 850 mg of metformin twice daily for 3 months. In group 2, 15 women received 4 mg of rosiglitazone for 3 months. In both groups, body mass index, menstrual pattern, and plasma total Hcy, insulin, glucose and lipid metabolism parameters were recorded at baseline and at 3 months. Hcy levels increased from 8.93+/-0.49 to 11.26+/-0.86 micromol/l (P = 0.002) and from 10.70+/-0.86 to 12.36+/-0.81 micromol/l (P = 0.01) in the metformin and rosiglitazone groups, respectively. Apolipoprotein (Apo) A1 levels increased from 127.10+/-6.85 to 145.7+/-7.18 mg/dl (P = 0.018) in the metformin group. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein (a) and Apo B levels decreased in the metformin group, but the change was not significant. Total-C levels decreased from 161.15+/-8.94 to 150.23+/-8.73 mg/dl (P = 0.026), HDL-C decreased from 43.13+/-2.65 to 39.15+/-2.52 mg/dl (P = 0.005) and LDL-C levels decreased from 93.83+/-6.06 to 80.7+/-2.30 mg/dl (P = 0.021) in the rosiglitazone group. Treatment with insulin sensitizers in women with PCOS may lead to increases in Hcy levels.