Serum Homocysteine In Patients Research Articles

Dapagliflozin's effect on serum homocysteine in patients with hypertension complicated with insulin resistance.

Most patients with hypertension are complicated with insulin resistance (IR), which is one of the risk factors of hypertension and can increase the level of serum homocysteine (Hcy) by affecting Hcy's metabolic enzyme and insulin level. Investigations in recent years have shown that Hcy is an independent risk factor for cardiovascular diseases. At present, folic acid is the prominent medicine used to reduce Hcy, but its effection for Hcy has an obvious individual difference, which is closely related to individual genes. Moreover, folic acid is chiefly used in patients with Hcy ≥15μmol/L, but Hcy ≥10μmol/L has had an adverse effect on the cardiovascular system. Randomized clinical trials have shown that dapagliflozin can improve IR. Therefore, whether it can reduce Hcy has become a new direction. This study was a retrospective case-control study. Patients with high serum Hcy and hypertension complicated with IR were divided into two groups: the dapagliflozin group (n=166) and the control group (n=198). Before and after 12weeks of treatment, the changes in serum Hcy and IR index were measured and compared. We found that dapagliflozin could reduce the serum Hcy level of patients with hypertension and IR to a certain extent. Dapagliflozin could be a viable option for hypertension complicated with IR and hyperhomocysteinemia. However, these findings need to be further confirmed in future randomized clinical trials with a large number of samples.

Study of serum homocysteine in patients of type-2 diabetes mellitus with and without hypertension

Study of serum homocysteine in patients of type-2 diabetes mellitus with and without hypertension

Association between serum folate with inflammatory markers, disease clinical activity and serum homocysteine in patients with inflammatory bowel disease. Does folate level have an effect on maintaining clinical remission?

Background:Folate is an important vitamin with protective effect against some human diseases. The aim of this study was to evaluate the relationship between serum folate levels, inflammatory markers and disease clinical activity in patients with inflammatory bowel disease (IBD).Methods:The participants were classified into two groups in which 38 IBD patients and 38 healthy controls were studied. Disease clinical activities were evaluated by means of established score systems. Serum folate, homocysteine and C-reactive protein and ESR were measured. Obtained data were analyzed with proper statistical methods and P- value less than 0.05 was considered as statistical significant.Results:The level of serum folate was significantly reduced in IBD patients with active disease compared to patients with clinical remission (p=0.043) and also healthy controls (p=0.008). Moreover, there was a significant inverse correlation between serum folate levels and C-reactive protein in IBD patients (r=-0.563 p=0.001). Conclusion: Serum folate levels is associated with inflammatory markers and disease clinical activity in IBD patients, therefore there is a possibility that disease clinical activity is reduced with adequate folate level. (www.actabiomedica.it)

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.

Homocysteinemia in relation to anemia in hypothyroid patients

Background Anemia and hypothyroidism are both common diseases in the community. Homocysteine (HCY) levels are increased in patients with hypothyroidism and methylenetetrahydrofolate reductase (MTHFR) deficiency is the most common genetic cause of hyperhomocysteinemia. The aim of the present study was to evaluate the level of serum HCY in patients with hypothyroidism and to study the relation of associated anemia with the serum level of HCY and MTHFR gene in patients with hypothyroidism. Patients and methods The study was conducted on 60 adult women attending the Endocrinology Outpatient Clinic of Al-Zahraa Hospital between September 2014 and June 2015 for proper diagnosis and management. Individuals of the study were divided into two main groups: group I (GI) with 30 hypothyroid patients, where 13 of them were postsurgical cases, and group II (GII) with 30 euthyroid individuals as a control group. Diagnosis was based on thyroid-stimulating hormone level reference values. Patients in GI were further classified into two subgroups: mild hypothyroid (subgroup I) and overt hypothyroid (subgroup II). Patient and control groups also were classified into anemic and nonanemic subgroups according to hemoglobin levels. The selected hypothyroid patients were women under thyroid hormone replacement therapy. Blood sample was obtained for proper investigations. Complete blood count, routine blood chemistry, serum iron level, thyroid function tests, vitamin B12 level, serum homocysteine (HCY), and MTHFR were performed. We performed a pilot study on MTHFR gene polymorphism. The C677T MTHFR gene mutation was detected in three of 10 patients and in two of 10 controls. No evidence of TT MTHFR gene mutation was observed in both patient and control groups. IBM SPSS statistics (version 23.0, USA, 2015) was used for data analysis. Results revealed the presence of anemia according to hemoglobin level (&lt;12 g/dl). In patients group (GI), 50% (15/30) as compared with 13.3% (4/30) in the control group (GII) had anemia. Serum iron level in patients group (GI) was deficient in 40% (11/30), whereas deficient in 16.7% (5/30) in control group (GII). Vitamin B12 deficiency was found to be 44% (11/25) in patients group (GI), whereas in the control group (GII) was 6.7% (2/30). Analysis by Wilcoxon's rank sum test, homocysteine (HCY) serum level showed a highly significant increase among patients (GI) as compared with control (GII). Ranked Spearman's correlation test for the patients (GI) and control (GII) showed a significant negative correlation between homocysteine (HCY) and MTHFR serum levels, whereas the correlation with red cell indices parameters was insignificant. Serum iron and B12 levels were significantly correlated in patient group (GI). Pearson χ 2 tests were done between both patients and control groups for the presence of anemia, iron deficiency, and elevated serum homocysteine (HCY) level and all revealed statistically significant results. Conclusion There is no significant correlation between homocysteinemia and anemia. However, the strong association between anemia and hypothyroidism is attributed mainly owing to combined iron and vitamin B12 deficiencies. This might explain the decreased response to treatment among the selected hypothyroid patients.

Correlation of serum homocysteine in patients with chronic heart failure and hypercoagulable state

Objective To investigate the correlation between serum homocysteine (HCY) and chronic heart failure (CHF) hypercoagulable state in patients. Methods A total of 105 cases of patients with CHF was divided into three groups according to the New York Heart Association (NYHA) classification standard functions: heart functional grade II group (42cases), cardiac function grade III group (35 cases) and, NYHA class IV group (28cases). At the same time, 40 healthy individuals were regard as the control group. HCY, fibrinogen (Fbg), D-dimer (DDI), HCY, N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by fasting venous blood samples which were collected within 24 hours after admission. Results Compared to the control group, the expression of Fbg, DDI, HCY and NT-proBNP increased, whereas, antithrombin Ⅲ (AT-Ⅲ) was reduced. Fbg, DDI, HCY, NT-proBNP, and AT-Ⅲ were found in all patient cases. Four groups were compared with each other, except for cardiac function Ⅱ group and the normal group had no significant difference between them (P>0.05), the difference between both other groups was significantly different (P<0.05), HCY had a positive correlation with Fbg, DDI, and NT-proBNP (r=0.268, 0.295, and 0.404, P<0.05), and negative correlation with AT-Ⅲ (r=-0.240, P<0.05). Conclusions HCY might be a reliable indicator as a judge of CHF patients with hypercoagulable state, to detect HCY, FBG, DDI, and AT-Ⅲ in CHF patients. It benefits for judging thrombosis risk and determining the severity of the diseases. Anticoagulant therapy might be beneficial to reduce the long-term adverse events. Key words: Homocysteine/ME; Heart failure/ME/PA; Blood coagulation disorders/ME

Analysis of Serum Homocysteine and Risk of Coronary Heart Disease in Patients with Pseudoexfoliation Syndrome

Purpose: To investigate levels of serum homocysteine in patients with pseudoexfoliation syndrome and the association between serum homocysteine levels and risk of coronary heart disease. Methods: From March 2013 to September 2013, 37 patients with pseudoexfoliation syndrome and 59 age-matched patients (control group) were enrolled in this prospective study. Serum homocysteine levels were compared between the 2 groups. We compared the estimated 10-year risk of coronary heart disease based on Framingham risk score between the 2 groups. Additionally, we analyzed correlations between risk of coronary heart disease and serum homocysteine levels. Results: The mean homocysteine level of patients with pseudoexfoliation syndrome was significantly higher than the control group (13.3 ± 6.8 μmol/L vs. 10.0 ± 5.2 μmol/L, p = 0.009). The rate of high risk defined as a 10-year coronary heart disease risk >20% in the patients with pseudoexfoliation syndrome was significantly higher than in the control group (21.4% vs. 4.4%, p = 0.048). Correlation between serum homocysteine levels and estimated 10-year risk of coronary heart disease was statistically significant (r = 0.578, p < 0.001). Conclusions: Hyperhomocysteinemia and high risk of coronary heart disease were observed in patients with pseudoexfoliation syndrome. Therefore, we suggest efforts to prevent coronary heart disease in pseudoexfoliation syndrome patients with hyperhomocysteinemia are necessary. J Korean Ophthalmol Soc 2016;57(3):461-467

Effect of Vitamin B12 supplementation on serum homocysteine in patients undergoing hemodialysis: A randomized controlled trial.

Clinical studies have shown that hyper-homocysteinemia is a potent independent risk factor for cardiovascular diseases, and many different methods have been investigated for lowering it in hemodialysis (HD) patients. Our study investigated the effect of Vitamin B 12 supplementation on serum homocysteine levels in these patients. This randomized trial was conducted on 140 HD patients. They were randomly distributed by lottery method into two groups: intervention and control. In the intervention group, 100 μg/mL of Vitamin B 12 was intravenously injected two times a week, for eight weeks. No intervention was performed in the control group. Serum levels of homocysteine, hemoglobin (Hb), and hematocrit (Hct) were measured at the beginning and again after eight weeks (2 months) of treatment. About 91% of the patients had hyperhomocysteinemia (serum homocysteine >15 μmol/L). The median baseline levels of serum homocysteine in the intervention and control groups were 31.9 and 26.9 μmol/L, respectively (P = 0.1). After eight weeks, the median homocysteine level reduced significantly in the Vitamin B 12 group to 22.2 versus 28.4 μmol/L in control group (P = 0.006). The mean Hb and Hct also changed significantly during our study (12.3 vs. 11.4 g/dL; P = 0.003 and 37.9 vs. 35.3%; P = 0.02, respectively). Our results demonstrated the existence of a statistical negative relationship between Vitamin B 12 and serum levels of homocysteine. Detailed investigations with larger sample sizes and longer-term use of Vitamin B 12 are recommended.

Impact of Lycopene intervention on serum homocysteine in patients of Myocardial Infarction

Introduction: Myocardial Infarction occurs due to any obstruction in coronary arteries leading to ischemia followed by infarction. It is characterized by systemic inflammation, elevated levels of inflammatory cytokines and atherosclerotic plaques. Plaque formation and Inflammation are significant contributor in the pathophysiology of MI. Antioxidants slow the progression of MI because of their ability to inhibit inflammatory processes. The aim of this study was to test an intervention in patients with MI to assess the effect of dietary lycopene on one of the independent risk factor for MI i. e Serum Homocysteine. Methods: Sixty participants with MI were randomly assigned to two groups: with lycopene intervention and without intervention. The intervention group received 27.212 mg of lycopene per day by drinking 1 serve (approx. 243 grams) of tomato soup for 90 days. Serum lycopene, and Serum Homocysteine were measured. Results: Plasma lycopene levels increased in the intervention group as compared with the non intervention group (0.50 µmol/L to 0.75 µmol/L, P = .002; 0.55 µmol/L to 0.57 µmol/L). Mean serum Homocysteine levels decreased significantly in the intervention group. The mean serum Homocysteine in pre intervention group was 29.77 µmol / L with S.D of 6.97 µmol / L and in post intervention subjects was 11 µmol / L with S.D of 1.96 µmol / L with a p value of 0.0001 which is statistically significant. Conclusions: These findings show that the antioxidant Lycopene in a 90-day intervention of tomato soup significantly decreases S. Hcy (Homocysteine) levels in a sample of patients with MI.

Cognitive and neurochemical alterations in hyperhomocysteinemic rat

Accumulating data have shown that the level of serum homocysteine in patients with mild cognitive impairment, vascular dementia and Alzheimer's disease is higher than normal while the underlying mechanism is not fully understood. Here, a hyperhomocysteinemic rat model was made by maintaining rats on a diet high in methionine. The cognitive behavior, level of monoamine neurotransmitters in brain homogenates and brain-derived neurotrophic factor (BDNF) in cerebral spinal fluid (CSF) were compared between high-methionine diet and control group. The high-methionine diet group presented longer mean latency of escape and lesser time in target quadrant in morris maze test, lower level of serotonin and dopamine in cortex homogenates and lower level of BDNF in CSF. Together, our findings provide evidence that hyperhomocysteinemia could cause alterations of monoamine and neurotrophic factor, which might be further pathogenetic mechanisms underlying the cognitive deterioration.

The concentration of homocysteine in patients after ischemic brain stroke and vascular dementia

Introduction: The aim of this study is to examine whether moderate hiperhomocysteinemia is an independent risk factor for cerebral infarction.Methods: We have measured homocysteine levels in 50 patients with ischemic stroke during acute phase and postacute phase, 50 patients diagnosed with vascular dementia and healthy group of 50 subjects. Homocysteine concentration in serum was measured, on the basis of fluorescent polarisation measuring.Results: The study demonstrated that homocysteine concentration was 16.93 µmol/L in the patient group with ischemic stroke, and in the group of patients with vascular dementia was 20.39 µmol/L. Homocysteine increases during the postacute phase of ischemic stroke after 7 days for 1.54 µmol/L and 14 days for 3.66 µmol/L compared to the concentration of homocysteine after the first hours of hospitalization. Using Wilcoxon signed ranks and Mann-Whitney (P &lt; 0.05) tests we got significant difference between homocysteine concentration at acute phase and post-acute phase of ischemic stroke and it was significant difference between concentrations of homocysteine in the acute and post-acute phase of ischemic stroke and vascular dementia. The Spearman correlation test was found signifiant correlation between the number of strokes and the concentration of homocysteine in serum of patients with vascular dementia.Conclusions: The homocysteine concentration rises significantly during of acute phase of ischemic brain stroke, and it is significantly increased during post-acute phase, which is a predictor factor for further development of vascular dementia, or a new ischemic brain stroke.

Metabolic syndrome and serum homocysteine in patients with bipolar disorder and schizophrenia treated with second generation antipsychotics

There is accumulating evidence for an increased prevalence of metabolic syndrome (MetS) in bipolar patients, which is comparable to the prevalence of MetS in patients with schizophrenia. Hyperhomocysteinaemia has emerged as an independent and graded risk factor for the development of cardiovascular disease (CVD), which is, at the same time, the primary clinical outcome of MetS. The aim of this study was to ascertain if the presence of MetS was associated with hyperhomocysteinaemia in patients with bipolar disorder ( N = 36) and schizophrenia ( N = 46) treated with second-generation antipsychotics (SGA). MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria and the cut-off point for hyperhomocysteinaemia was set up at 15 μmol l –1. Results of the study indicated that the presence of the MetS is statistically significantly associated with the elevated serum homocysteine in all participants. As hyperhomocysteinaemia has emerged as an independent risk factor for psychiatric disorder and CVD, it could be useful to include fasting homocysteine serum determination in the diagnostic panels of psychiatric patients to obtain a better assessment of their metabolic risk profile.

Elevated Serum Homocysteine in Patients with Coronary Vasospasm

Background: Homocysteine is a metabolite of methionine with atherogenic properties via endothelial dysfunction. Endothelial dysfunction is one of main pathophysiologic mechanisms of coronary vasospasm. We examined the relationship between the risk of patients with coronary vasospasm and serum total homocysteine (tHcy), folate, vitamin B12, and plasma vitamin B6. Methods: Fasting serum tHcy, folate, vitamin B12, and plasma vitamin B6 concentrations were measured in 25 patients (15 men, age 52.8±10.1) with coronary vasospasm and compared with 22 healthy control subjects matching in age and sex (10 men, age 52.7±9.2). Serum tHcy concentration was higher in the vasospasm group than in the control group (14.8±5.3 vs 10.1±2.5 μmol/L, p<0.001). Results: Serum folate (6.3±1.0 vs 10.2±4.5 ng/mL, p<0.001) and vitamin B12 concentration (544.8±181.7 vs 1004.9±567.1 pg/mL, p<0.001) were lower in vasospasm group. There was no significant difference in plasma vitamin B6 concentration between the two groups (77.8±44.3 and 95.8±63.4 nmol/L). Conclusions: These data support the hypothesis that elevated serum tHcy is a risk factor for coronary vasospasm. Low folate and vitamin B12 levels in patients with coronary vasospasm suggest that these agents contribute therapeutically to the treat

2P-0577 Effects of atorvastatin on plasma fibrinogen, plasminogen activator inhibitor-1 (PAI-1) and serum homocysteine in patients with familial hypercholesterolaemia (FH) and non-familial hypercholesterolaemia (NFH)

2P-0577 Effects of atorvastatin on plasma fibrinogen, plasminogen activator inhibitor-1 (PAI-1) and serum homocysteine in patients with familial hypercholesterolaemia (FH) and non-familial hypercholesterolaemia (NFH)

Serum homocysteine in pre-eclampsia and eclampsia

Pre-eclampsia and eclampsia are common obstetrical problem causing adverse effects on pregnancy outcome. Large bodies of evidences suggest that hyperhomocysteinemia is a causal factor of pre-eclampsia/eclampsia. This study designed to explore the association between hyperhomocysteinemia and pre-eclampsia/eclampsia, the knowledge of which expected to be used for prevention of pre-eclampsia and eclampsia. In a case-control study serum homocysteine was measured in 136 controls (healthy pregnant), 84 pre-eclamptic and 120 eclamptic pregnant women. Serum homocysteine in patients with pre-eclampsia (9.54 +/- 3.21 micromol/L) and eclampsia (10.57 +/- 3.39 micromol/L) found to be significantly increased compared to controls (6.86 +/- 2.47 micromol/L) (p < 0.001). Between pre-eclampsia and eclampsia, homocysteine found to be raised more in eclampsia compared to pre-eclampsia (p < 0.03). In conclusion, hyperhomocysteinemia is associated with pre-eclampsia as well as eclampsia, but in eclampsia the severity of homocysteine elevation is more compared to that in pre-eclampsia.