Serum Homocysteine Research Articles

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.

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.

Association of MTHFR C667T Polymorphism, Homocysteine, and B Vitamins with Senile Cataract.

Senile cataract has become the leading cause of visual impairment and even blindness in the world, but there are few reports on its relationship with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. This study is aimed to investigate the correlation between MTHFR gene polymorphisms or its enzyme metabolites and senile cataract. From January 2019 to June 2020, 663 patients with senile cataract at the Mianyang Central Hospital were enrolled as the observation group, and 646 healthy subjects were randomly selected as the control group. MTHFR gene polymorphisms (i.e., CC, CT, or TT genotypes) and serum homocysteine (HCY), folic acid (FOL), vitamin B12 (VitB12), and vitamin B6 (VitB6) levels were detected. The mutation rate of MTHFR C677T and HCY levels in the observation group were significantly higher than those in the control group, whereas FOL, VitB12, and VitB6 were significantly lower. With an increase in the MTHFR C677T mutation, HCY showed an upward trend, whereas FOL and VitB12 showed a decreasing trend in both the observation and control groups. Multiple logistic regression analysis showed that HCY and FOL were associated with senile cataract and MTHFR mutations; VitB12 was only associated with senile cataract. Compared to that with the CC genotype, CT and TT genotypes were associated with an increased senile cataract risk. Monitoring MTHFR gene polymorphisms and changes in serum HCY, FOL, and VitB12 levels could provide references in predicting senile cataract.

Assessment of the Anti-hypertensive and Hyperhomocysteinemic Activity of Aqueous Extracts of Tomato (<i>Lycopersicon esculentum MILL</i>) Grown in Ivory Coast

The tomato (<i>Lycopersiconesculentum</i> Mill) is a herbaceous plant of the Solanaceae family widely cultivated for its fruit. It is one of the most consumed fruits in the world because of its nutritional potential. Indeed, tomato is rich in secondary metabolites and compounds with antioxidant power known for their beneficial effects on health. This study aims to evaluate the antihypertensive and antihyperhocysteinemic activity of two varieties of tomatoes grown in Côte d'Ivoire, namely <i>Locale côtelette</i> and <i>Cobra F1</i>. To do this, rats made hypertensive and hyperhomocysteinemic were treated at a dose of 50 and 100 mg/kg bw for 8 days with the extracts of these tomatoes. At the end of this treatment, the results indicate a decrease in the serum level of LDL-cholesterol and creatinemia respectively of 79.92% and 18.82% in comparison with those of hypertensive rats which did not undergo any treatment. In addition, serum homocysteine level decreased by 35% compared with untreated hyperhomocysteinemic rats. Moreover, a 13.33% increase in serum HDL-cholesterol was observed. In view of the results obtained, regular consumption of tomatoes could help fight against high blood pressure, atherosclerosis, renal failure and prevent cardiovascular complications such as thromboembolic diseases.

Ischaemic stroke with multi-focal venous and arterial thrombosis due to hyperhomocysteinemia: anabolic androgenic steroid use and MTHFR c.667 C > T variant – a case report

BackgroundSeverely elevated serum homocysteine is a rare cause of ischaemic stroke and extra-cranial arterial and venous thrombosis. Several factors can lead to mild elevation of homocysteine including dietary folate and B12 deficiency, and genetic variants of the methylenetetrahydrofolate reductase (MTHFR) enzyme. The use of Anabolic androgenic steroid (AAS) is under-reported, but increasingly linked to ischaemic stroke and can raise homocysteine levels.Case ReportWe present a case of a man in his 40s with a large left middle cerebral artery (MCA) territory ischaemic stroke and combined multifocal, extracranial venous, and arterial thrombosis. His past medical history was significant for Crohn’s disease and covert use of AAS. A young stroke screen was negative except for a severely elevated total homocysteine concentration, folate and B12 deficiencies. Further tests revealed he was homozygous for the methylenetetrahydrofolate reductase enzyme thermolabile variant (MTHFR c.667 C > T). The etiology of this stroke was a hypercoagulable state induced by raised plasma homocysteine. Raised homocysteine in this case was likely multifactorial and related to chronic AAS use in combination with the homozygous MTHFR c.677 C > T thermolabile variant, folate deficiency and, vitamin B12 deficiency.ConclusionIn summary, hyperhomocysteinemia is an important potential cause of ischaemic stroke and may result from genetic, dietary, and social factors. Anabolic androgenic steroid use is an important risk factor for clinicians to consider, particularly in cases of young stroke with elevated serum homocysteine. Testing for MFTHR variants in stroke patients with raised homocysteine may be useful to guide secondary stroke prevention through adequate vitamin supplementation. Further studies looking into primary and secondary stroke prevention in the high-risk MTHFR variant cohort are necessary.

Prognostic biomarkers in and selection of surgical patients with hepatocellular carcinoma.

Prognostic biomarkers in and selection of surgical patients with hepatocellular carcinoma.

Potential mechanism for hyperhomocysteinemia in Greyhound dogs.

Greyhounds have been reported to have hyperhomocysteinemia (HHC), but the underlying mechanisms and clinical implications are unclear. Our primary aim was to assess serum concentrations of homocysteine (HCy) and related analytes in Greyhounds and to identify a likely metabolic pathway for HHC. A secondary aim was to determine whether HHC is associated with evidence of oxidative stress. Healthy pet Greyhounds (n = 31) and non-sighthound control dogs (n = 15). Analysis of serum HCy, cobalamin, folate, and methionine, and plasma cysteine, glutathione, and total 8-isoprostane concentrations. Homocysteine concentrations were higher in Greyhounds (median, 25.0 μmol/L) compared to controls (13.9 μmol/L; P < .0001). Cobalamin concentrations were lower in Greyhounds (median, 416 ng/L) compared to controls (644 ng/L; P = .004) and were inversely correlated with HCy (r = -0.40, P = .004). Serum concentrations of folate, which is regenerated when HCy is converted to methionine, also were inversely correlated with HCy (r = -0.47, P = .002). Serum methionine concentrations were more than 4-fold lower in Greyhounds (median, 3.2 μmol/L) compared to controls (median, 15.0 μmol/L), but this difference was not significant (P = .3). Plasma cysteine, glutathione, and 8-isoprostane concentrations did not differ significantly between groups. Our findings suggest a primary defect in conversion of HCy to methionine in Greyhounds, with related impaired folate generation. Ineffective cycling by methionine synthase could lead to secondary cobalamin depletion. Notably, low serum folate and cobalamin concentrations can be observed in Greyhounds without signs of intestinal disease.

Evaluation of homocysteine, vitamin, and trace element levels in women with gallstones

ObjectiveIt was aimed to examine the changes in homocysteine, folic acid, and vitamin B12, which metabolize homocysteine from the body, and trace elements (zinc, copper, selenium, nickel) that affect the structure of tissues and epithelium in female patients with gallstone disease. Moreover, it was aimed to investigate the contribution of these selected parameters to the etiology of the disease and their usability in treatment according to the findings obtained. Materials and MethodsEighty patients, including 40 female patients (Group I) and 40 completely healthy female individuals (Group II) were included in this study. Serum homocysteine, vitamin B12, folate, zinc, copper, selenium, and nickel levels were evaluated. Electrochemiluminescence immunoassay was used in the analysis of vitamin B12, folic acid, and homocysteine levels, and the ICP-MS method was used in the analysis of trace element levels. ResultsHomocysteine levels in Group I were statistically significantly higher than in Group II. In terms of vitamin B12, zinc, and selenium, Group I levels were found to be statistically significantly lower than group II. There was no statistically significant difference between Group I levels and Group II in terms of copper, nickel, and folate. ConclusionIt was suggested that homocysteine, vitamin B12, zinc, and selenium levels should be determined in patients with gallstone disease and that vitamin B12, which is especially important in the excretion of homocysteine from the body, and zinc and selenium, which prevent the free radical formation and protect from its effects, should be added to the diets of these patients.

Serum homocysteine level is an independent risk factor for 1-year stroke recurrence in patients with acute ischemic stroke and H-type hypertension: results from the Xi'an stroke registry study of China.

H-type hypertension has a high prevalence in China. However, the association of serum homocysteine levels with 1-year stroke recurrence in patients with acute ischemic stroke (AIS) and H-type hypertension has not been studied. A prospective cohort study of patients with AIS admitted to hospitals between January and December 2015 in Xi'an, China, was conducted. Serum homocysteine levels, demographic data, and other relevant information were collected from all patients upon admission. Stroke recurrences were routinely tracked at 1, 3, 6, and 12 months after discharge. The blood homocysteine level was studied as a continuous variable and tertiles (T1-T3). A multivariable Cox proportional hazard model and a two-piecewise linear regression model were utilized to evaluate the association and ascertain the threshold effect regarding the serum homocysteine level and 1-year stroke recurrence in patients with AIS and H-type hypertension. Overall, 951 patients with AIS and H-type hypertension were enrolled, of whom 61.1% were male. After adjusting for confounders, patients in T3 had a significantly increased risk of recurrent stroke within 1 year, compared with those in T1 as the reference (hazard ratio = 2.24, 95% confidence interval: 1.01-4.97, p = 0.047). Curve fitting showed that serum homocysteine levels were positively curvilinearly correlated with 1-year stroke recurrence. Threshold effect analysis showed that an optimal threshold of serum homocysteine level <25 μmol/L was effective in reducing the risk of 1-year stroke recurrence in patients with AIS and H-type hypertension. Elevated homocysteine levels in patients with severe neurological deficits on admission significantly increased the risk of 1-year stroke recurrence (p for interaction = 0.041). In patients with AIS and H-type hypertension, the serum homocysteine level was an independent risk factor for 1-year stroke recurrence. A serum homocysteine level of ≥25 μmol/L significantly increased the risk of 1-year stroke recurrence. These findings can inform the creation of a more precise homocysteine reference range for the prevention and treatment of 1-year stroke recurrence in patients with AIS and H-type hypertension and provide a theoretical foundation for the individualized prevention and treatment of stroke recurrence.

Plasma lipid profiles and homocysteine levels in anti-N-methyl-D-aspartate receptor encephalitis.

We aimed to investigate whether lipid profiles and homocysteine levels in patients with anti-N-methyl-D-aspartate receptor encephalitis are related to clinical presentation and prognosis, which may contribute to further research on the pathogenesis and treatment of this disease. This study included a total of 43 patients with anti-N-methyl-D-aspartate receptor encephalitis and 43 sex-age-matched healthy controls. Baseline demography, clinical data, patient outcomes, and ancillary examination results were recorded. Patients were followed up every 2-3 months during the first year. The modified Rankin Scale score was used to evaluate the therapeutic effect and clinical outcome. Among the 43 patients included in this study, 55.81% were male, the mean age of onset was 27 years old, and the median modified Rankin Scale score on admission was 3.0. Apolipoprotein A-1 was significantly lower in patients with anti-N-methyl-D-aspartate receptor encephalitis compared with healthy controls (p = 0.004). Compared with healthy controls, homocysteine (p = 0.002), apolipoprotein B (p = 0.004), Lpa (p = 0.045), and apolipoprotein B/apolipoprotein A-1 (p = 0.001) were significantly increased in patients with anti-N-methyl-D-aspartate receptor encephalitis. According to the modified Rankin Scale scores, 6 months after discharge, 72.09% of patients had a good prognosis and 27.91% had a poor prognosis. In the good prognosis group, age (p = 0.031), lipoprotein a (p = 0.023), apolipoprotein A-1 (p = 0.027) at baseline, and the modified Rankin Scale score on admission (p = 0.019) were significantly higher than those in the poor prognosis group. This study suggests the possibility that serum lipid profile and homocysteine play an important role in the pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis, providing support for lipid-lowering treatment of anti-N-methyl-D-aspartate receptor encephalitis patients.

Maternal Hyperhomocysteinemia as a Predictor of Placenta-Mediated Pregnancy Complications: A Two-Year Novel Study.

Background Placenta-mediated pregnancy complications (PMPCs) are a significant contributor to adverse maternal and fetal outcomes. Though the exact cause of the array of pregnancy-related vascular disorders is still unknown, increased maternal serum homocysteine (Hct) levels have been linked to the pathophysiology. Hyperhomocysteinemia (HHct) has been strongly linked with the risk of developing PMPCs such as preeclampsia (PE), fetal growth restriction (FGR), intrauterine fetal death (IUFD), preterm births and placental abruption. Methodology The present observational study was carried out on 810 low-risk antenatal women in their early second trimester (13-20 weeks gestation age) in the department of obstetrics and gynecology of a tertiary care rural hospital to identify the significance of abnormally raised maternal serum Hct level in developing PMPCs. Results Of the 810 participants studied, 224 (27.65%) had raised Hct levelswhereas the rest of the 586 (72.35%) participants had normal Hct levels. The mean Hct level of raised homocysteine group (18.59 ± 2.46 micromol/L) was substantially raised than the normal Hct group (8.64 ± 3.1 micromol/L). It was observedthat women with elevated serum Hct levels developed PMPCs significantly morethan women with normal serum Hct levels (p-value <0.05).Among HHct subjects, 65.18% developed PE, 34.38% had FGR, 28.13% had a preterm delivery, 4.02% had abruptio placentae and 3.57%had IUFD. Conclusions The focus of the current study is on an easy and quick intervention suchas assessing the often-ignored levels of Hct duringpregnancythat can help predict and prevent PMPCs. It also highlights the necessity for well-thought-out large-scale studies and trials to further examine the phenomena, as pregnancy may be the only time whenrural women willhave the opportunityto receive advice and tobe tested for HHct.

Intended and Unintended Benefits of Folic Acid Fortification-A Narrative Review.

Inadequate folate intake during pregnancy is the leading cause of the development of neural tube defects (NTDs) in newborns. For this reason, mandatory fortification of folic acid, a synthetic, easily bioavailable form, in processed cereals and cereal products has been implemented in the US since 1 January 1998 to reduce the risk of NTD in newborn children. This report aimed to review the literature related to the impact of mandated folic acid fortification on the intended and unintended benefits to health. Potential adverse effects were also discussed. We searched Pubmed, Google Scholar, Embase, SCOPUS, and Cochrane databases for reports. About 60 reports published between January 1998 and December 2022 were reviewed, summarized, and served as background for this review. The intended benefit was decreased prevalence of NTDs, while unintended benefits were reduction in anemia, blood serum homocysteine, and the risk of developing cardiovascular diseases. Potential issues with folic acid fortification are the presence of unmetabolized folic acid in circulation, increased risk of cancer, and the masking of vitamin B-12 deficiency. From a health perspective, it is important to monitor the impact of folic acid fortification periodically.

Homocysteine serum levels correlate with the number of failed IVF cycles even when within normal range.

Repeated implantation failure is a common challenge in daily practice. Homocysteine and vitamin B12 have been associated with reproductive processes among patients undergoing in vitro fertilization; however, their involvement in repeated implantation failure has not been assessed. We explored possible associations of serum homocysteine and vitamin B12 with repeated implantation failure. A retrospective analysis of 127 women who underwent ≥ 3 unsuccessful embryo transfers during 2005-2016, at the Fertility and In Vitro Fertilization Unit at Carmel Medical Center. After at least 3 IVF failures serum levels of homocysteine and vitamin B12 were measured. The mean patient age was 33.5 ± 5.2years. The mean number of embryo transfers was 4.6 ± 1.5. The mean total cumulative number of embryos transferred was 10.4 ± 5.2. Mean serum levels of homocysteine were 8.6 ± 3.7µM/L, and of vitamin B12 were 302.5 ± 155.3pg/ml. Homocysteine levels were within the normal range (< 14µM/L) in 95.8% of the patients. Yet, the levels of homocysteine correlated with both the number of failed embryo transfers (r = 0.34, p = 0.004) and the total cumulative number of transferred embryos (r = 0.36, p = 0.002). Our findings suggest an association between serum homocysteine levels and the occurrence of repeated implantation failure, even when homocystein levels were within the normal range. It should be studied whether nutritional supplementation to modulate serum homocysteine levels may improve treatment outcome.

Dumansız Tütün "Maraş Otu"nun Homosistein ve Kardiyovasküler Risk Parametreleri Üzerine Etkileri

Objective: This study aims to investigate the relationship between smokeless tobacco (Maras powder) and cigarette consumption with homocysteine, Paraoxonase-1 (PON-1), Arylesterase (ARE), and Lipoprotein-a (Lp (a)), which are known as risk factors for cardiovascular diseases.&#x0D; Material and Methods: The individuals included in the study were divided into three groups as Maras powder users (n = 38), cigarette smokers (n = 38), and healthy volunteers who did not use either tobacco group (n = 38). Serum homocysteine, PON-1, ARE, and Lp (a) levels of all participants were examined.&#x0D; Results: When the groups are compared, the highest homocysteine level was in the Maras powder group. While the difference between the control group and the Maras powder group was statistically significant, the difference between the control and smokers groups was statistically insignificant. Although PON values were lower in both the Maras powder and smokers groups than the control group, the difference was significant only in the smoking group. ARE was significantly lower, and Lp (a) was significantly higher in both tobacco smokers groups compared to the control group.&#x0D; Conclusion: Serum homocysteine, PON-1, ARE, and Lp (a) level are associated with Maras powder use. Homocysteine may be a useful early marker for cardiovascular disease in those who use Maras powder.

Clinical detection of total homocysteine in human serum using surface-enhanced Raman spectroscopy

Cardiovascular diseases cause enormous morbidity and mortality worldwide. Excessive blood total homocysteine (tHcy) is an independent risk factor for cardiovascular diseases. Therefore, it is imperative to measure the content of tHcy in human blood. However, the currently available analytical methods have the disadvantages such as being time-consuming and expensive. Herein, we propose a rapid clinical quantification of tHcy in human serum using high-performance Ag Nanopolyhedra (Ag NPOLY) as surface-enhanced Raman spectroscopy (SERS) substrates. Generally, 80% of homocysteine (Hcy) in serum is oxidized, and only 20% of Hcy is free. To understand this behavior, we explored the reduction effect of tris(2-carboxyethyl) phosphine (TCEP) on serum Hcy at different pH. The results confirmed that our method can detect 2 µM of Hcy in human serum. As a proof-of-concept, the developed method was applied to the actual clinical detection of human serum tHcy, and the serum of 5 hyperhomocysteinemia (HHcy) patients was verified. Moreover, the obtained, results were consistent with high-performance liquid chromatography (HPLC) results. The linear correlation coefficient of the two methods was 0.9766. Importantly, our analysis can be completed within 15 min, while HCLP requires more than 1 h. Overall, we have successfully developed a rapid SERS-based quantitative method for human serum tHcy, which can provide a new solution for the clinical diagnosis of cardiovascular diseases in the future.

Serum Level of Homocysteine, Folate, and Vitamin B12 in Adult Epileptic Patients Under Antiepileptic Therapy

Background: Epilepsy is a medical condition that requires long-term treatment with antiepileptic drugs. Different epidemiological studies revealed an increased risk of atherogenic cardiovascular diseases in patients under antiepileptic therapy. The possible etiologic suggestion is alterations of the serum homocysteine, folate, and vitamin B12 metabolism. Objective: To evaluate serum homocysteine, folate, and vitamin B12 level in patients under antiepileptic monotherapy. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2017 to June 2018 through purposive sampling. In this study, forty diagnosed patients under antiepileptic monotherapy and forty age and sex-matched apparently healthy control were selected according to selection criteria, from OPD of the Neurology department, Dhaka medical college hospital. Results: In patients under antiepileptic therapy, mean (±SD) of serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 14.15±3.4, 13.61±2.02, 361.78±41.26 respectively. In the healthy control group, serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 8.78±2.59, 16.71±2.06 and 366.69±44.15 respectively. Serum homocysteine level was found higher and folate level was found lower in patients with antiepileptic therapy which were statistically significant (p&lt;0.001). But serum B12 level difference was found statistically non-significant. Serum homocysteine level has a positive correlation (p-value 0.001, r value 0.71) and serum folate has a negative correlation (p-value 0.001, r value -0.65) with the duration of antiepileptic therapy. Conclusion: A higher level of serum homocysteine and a lower level of folate was found in patients under antiepileptic therapy. But there was no significant change in the serum vitamin B12 level of these patients. J Rang Med Col. March 2023; Vol. 8, No. 2:44-48

Impact of correction of homocisteinemia on clinical outcomes of lung damage associated with COVID-19 coronavirus infection

Aim. To assess the effect of serum homocysteine levels on treatment outcomes in patients with COVID19-associated lung damage, depending on the use of folic acid in complex treatment.Materials and methods. An open, prospective comparative study included 71 hospitalized adult patients with COVID-19-associated lung disease who did not require mechanical ventilation. The main group included 51 patients who received folic acid 15 mg per day in a complex treatment in a fixed combination with pyridoxine hydrochloride and cyanocobalamin. The comparison group included 20 patients in whose therapy folic acid was not used.Results. The use of folic acid was accompanied by a decrease in serum homocysteine concentration by 2.120 (-0.230; 3.680) µmol/L (p=0.004). When constructing a logistic regression model, the effect of a decrease in serum homocysteine (OR 1.289; 95% CI 1.026‒1.620; p=0.029), methylenetetrahydrofolate reductase MTHFR C677T genotype (OR 10.897; 95% CI 1.240‒95.772; p=0.031) on the achievement of 7th day of hospitalization, the cessation of isolation of SARS-CoV-2 virus RNA from the respiratory tract. Multiple linear regression analysis showed an association between the duration of hypoxemic respiratory failure, determined with SaO2≤93%, with the degree of change in serum homocysteine concentration after treatment, single nucleotide polymorphisms of methylenetetrahydrofolate reductase MTHFR C677T, methionine synthase MTR A2756G and methionine synthase reductase MTRR A66G, initial volume of lung damage ≥50% according to CT data, indicators of D-dimers, C-reactive protein, hemoglobin, platelets, concomitant hypertension, diabetes mellitus (R=0.699; R2=0.489; p=0.005).Conclusion. The dynamics of the decrease in serum homocysteine after treatment is an important predictor of the cessation of isolation from the respiratory tract of the SARS-CoV-2 virus RNA on the 7th day of treatment, reducing the duration of hypoxemic respiratory failure in patients with lung damage associated with COVID-19 infection.

The diagnostic value of echocardiography combined with serum Hcy and PCSK9 in coronary heart disease

ABSTRACT Coronary heart disease (CHD) is one of the most common cardiovascular diseases. This study analyzed the diagnostic value of echocardiography combined with serum homocysteine (Hcy) and proprotein convertase subtilisin 9 (PCSK9) in CHD. Here, 108 CHD patients were selected as the study group. Additionally, 108 patients with suspected CHD excluded by coronary angiography were selected as the control group. Serum Hcy and PCSK9 levels were detected by circulating enzymatic and biochemical analysis assay. The contrast echocardiography showed that the contrast agent filling velocity (β) and the maximum number of microbubbles (A) in the study group were declined compared to the control group. Serum Hcy and PCSK9 levels in the study group were higher than those in the control group. In addition, β, A, Hcy and PCSK9 are important influencing factors of CHD. The coronary artery disease branch numbers and the degree of stenosis in CHD patients were negatively correlated with β and A values, and positively correlated with serum Hcy and PCSK9 levels. β, A combined with serum Hcy and PCSK9 levels have diagnostic value for CHD, and are significantly correlated with the severity of CHD.

Evaluation of Maternal Serum Homocysteine in Pre eclampsia

Background: Pre-eclampsia affects about 2–8% of all pregnancies. It is one of the leading causes of maternal and perinatal morbidity and mortality hyperhomocysteinemia is considered as a risk factor for endothelial dysfunction and vascular disease. The vascular changes induced by homocysteine are similar to those with pre-eclampsia. The aim of the study is to identify the relationship between maternal serum homocysteine level and the development of pre-eclampsia.Method and patient: A case control study that was carried out in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital in Kirkuk-Iraq, during the period of eight months from 1st of Feb. till 1st of October 2021. It included 80 pregnant women with singleton viable pregnancy, gestational age of > 20 weeks. They were divided into two groups: Case group included 40 pregnant women who had diagnosed as pre eclampsia (mild and severe) and control group included 40 healthy normotensive pregnant women. Patients with multiple pregnancy, history of medical disease or tacking treatment for hypertension were excluded from the study. Blood sample was taken from each woman for biochemical study, serum homocysteine level was measured using ELISA technique.Result: In this study, pregnant women with pre-eclampsia had significantly higher mean of serum homocysteine compared with controls. Homocysteine level > 8.95 μmol/l is a predictor for pre-eclampsia. Out of 40 women with pre-eclampsia, 42.5% were mild, while the remaining 57.5% were severe. Pregnant women with severe pre eclampsia had significantly higher mean of serum homocysteine compared to those with mild pre-eclampsia. The level of tested biomarkers and homocysteine was tested between the two study groups to assess their rule in pre eclampsia.Conclusions: Maternal serum homocysteine biomarker represents an early non-invasive marker for diagnosis of pre eclampsia and to name the disease according to the severity.

A PROSPECTIVE CLINICAL STUDY OF SERUM BIOMARKERS WITH TREATMENT OUTCOME OF EPITHELIAL OVARIAN CANCER CASES

Introduction: Ovarian cancer has worst prognosis and high mortality rate due to delayed onset of symptoms and lack of proper screening test that leads to late diagnosis in the advanced stages. Folate and vitamin B12 are involved in one carbon metabolism as cofactor and also has a role in conversion of homocysteine to methionine. Aberration in these processes may amplify carcinogenesis. Objective: To analyse the role of serum level of CA125, Folate, Vitamin B12 &amp; Homocysteine as diagnostic tool in Epithelial Ovarian Cancer. Methods &amp; Materials: 35 diagnosed cases of epithelial ovarian carcinoma were collected from Outpatient and Inpatient Department of Obstetrics &amp; Gynaecology as per Eastern Cooperative Oncology Group performance status. Serum levels of CA125, Folate, Vitamin B12 and Homocysteine were assayed at the time of diagnosis, 3 months and 6 months post treatment. Comparison between pre and post treatment serum levels of parameters were analysed by Graph Pad Prism version 8.4.3. Results: Mean age of developing ovarian cancer is 51± 9 years. Pre-treatment Serum CA125 levels (mean 1021 ± 800.5 units/ml) &amp; Serum Homocysteine levels (mean 11.23 ± 2.164 ng/ml) were signicantly higher than 3 months &amp; 6 months post-treatment serum levels. Pretreatment Serum Folate levels (mean 3.231 ± 1.506 ng/ml) &amp; Serum Vitamin B12 levels (mean 280.6 ± 140.8 ng/ml) were signicantly lower than 3 months &amp; 6 months post-treatment serum levels. Conclusion: The serum levels of selected parameters were signicantly altered in cases of epithelial ovarian cancer &amp; plays an important role in process of carcinogenesis