RESUMO
The present study was undertaken to explore the relationship of plasma homocysteine with other biochemical parameters in ischemic heart disease. Plasma levels of total homocysteine was measured by HPLC-fluorescence detection with internal standard in 60 ischemic heart disease patients and were compared with 30 age matched normal healthy controls. The significant increase of plasma homocysteine was observed in both myocardial infarction and chronic stable ischemic heart disease patients when compared with the controls. The hyperhomocysteinemia appears be to due to increased body demand of vitamins such as folic acid, vitamin B(12), B(6), B(2) either alone or in combination to regulate normal homocysteine metabolism.
RESUMO
INTRODUCTION: Geographical and ethnic factors have recently been shown to have a significant role to play in cardiovascular diseases. The exact relationship between nutritional and geographical factors in cardiovascular diseases is not very clear. This study examined the relationship of hyperhomocysteinaemia with lipid profile and antioxidants in patients with ischaemic heart disease from rural areas in Maharashtra, India. METHODS: Blood cholesterol (total, high- and low-density lipoproteins cholesterol), triglycerides along with thiobarbituric acid reactive substances (TBARS), superoxide dismutase, glutathione peroxidase and catalase activities were measured in acute coronary syndrome (ACS) and chronic stable angina (CSA) patients from rural areas and in normal healthy controls from the same area. Plasma total homocysteine was measured by high pressure liquid chromatography with fluorescence detection. Folic acid and vitamin B12 were measured by chemiluminescence immunoassay. RESULTS: The relative lipid ratios were higher in the patients and had a poor correlation with antioxidants. Total homocysteine levels were significantly higher by almost three times more than the controls. TBARS levels also showed a similar pattern, whereas antioxidant enzymes showed a significantly greater fall in ACS than CSA. There was a definite inverse relationship between total homocysteine, TBARS and antioxidants in the patients. The levels of folic acid and vitamin B12 were 3-4 times higher in the patients compared to the controls. There was a poor correlation between the total homocysteine and vitamin levels in the patients. CONCLUSION: Blood homocysteine is a very important biomarker of cardiovascular diseases and must be evaluated along with other risk factors. There is a higher prevalence of hyperhomocysteinaemia in rural Indian patients. There appears to be a strong association of genetic factors in the development of ischaemic heart disease in Indian patients.