ABSTRACT
Background: The association of high serum homocysteine concentration and C- reactive protein as a risk factor for the acute coronary syndrome. The aim of study was to evaluate serum homocysteine and hs-CRP level in newly diagnosed ACS patients together with comparison of homocysteine and hs-CRP level in ACS patients with & without type 2 diabetes and also to find out the correlation between serum homocysteine and hs- CRP level among the ACS patient with and without type 2 DM.Material & Methods:This was a cross sectional study and total of 260 patients with new onset of ACS admitted in the CCU, Department of Cardiology, DMCH were included in the study during Jan, 2011 to Feb, 2012. Among them 72 ACS patients with type 2 diabetes was considered as group I and 188 ACS patients without diabetes was considered as group II. Serum total homocysteine level, hs-CRP level and traditional risk factors for ACS were documented from all the study population.Results:Most of the patients were found in 4th decade in both groups. Acute STEMI was more common clinical feature in both groups. The mean serum homocysteine level in all groups of ACS patients were significantly higher in patients without DM in comparison to type 2 DM. Similarly, the mean hs-CRP level in all groups of ACS patients were significantly higher in patients without type 2 DM. The mean serum homocysteine and hs-CRP level were significantly higher in nondiabetic ACS patients. However, dyslipidaemia was significantly higher in patients with type 2 DM. Hypertension, obesity and family history of ACS were not significant between two groups. There was no correlation found between serum homocysteine with serum hs-CRP in ACS patients with type 2 DM and ACS patients without DM respectively.Conclusion: So, both serum homocysteine and hs-CRP level in ACS patients were significantly higher in patients without DM. In ACS, C-reactive protein elevation was a better marker of extension of myocardial damage than homocyesteine. No correlation was found between serum homocysteine with hs-CRP level in ACS patients with and without type 2 DM respectively.
ABSTRACT
Background: Coronary Artery Disease (CAD) has a high prevalence in Asian Indians. The Acute Myocardial Infarction (AMI) or Ischemic Heart Disease is rapidly increasing in India and in the developing countries. India is on an epidemiological threshold of experiencing significant increase in cardiovascular diseases. This predilection to Coronary Heart Disease is attributable to a clustering of various risk factors. The factors implicated include: The lifestyle modifiable risk factors such as smoking, obesity, physical inactivity and those modifiable by lifestyle as well as pharmacotherapy such as lipid disorder, hypertension, and insulin resistance. The non-modifiable risk factors include age, sex and genetics. These are reasonably well established. The high rate of coronary heart disease however cannot be explained by the presence of these conventional risk factors alone. Of all the ethnic groups, people of Indian origin have one of the highest incidences of CAD. Aim and Objective: To study and establish correlation of Hyperhomocysteinemia with various coronary risk factors such as Age, Sex, socioeconomic status, and other lifestyle factors such as occupation, smoking, alcohol, tea/coffee, Dyslipidemia, hypertension, obesity and diabetes. Materials and Methods: The study was conducted in the department of Pathology at M.P. Shah Government medical college and Guru Gobind Singh hospital, Jamnagar- Gujarat; it was undertaken over a period of two years from August-2018 to August-2020. A total of 150 patients receiving In-patient care in the hospital were selected to enter the study. This was a cross-sectional study. Detailed clinical history and other important parameters as well as findings of all the concerned patients were collected. Estimation of serum homocysteine level done of all 150 patients. Results: This study was conducted in 150 patients admitted at a tertiary care center in Saurashtra region, for a duration of two years from August 2018-August 2020. The study was a cross-sectional study and included 150 patients who were diagnosed cases of coronary artery disease or Ischemic Heart Disease or previous history of Cardiac arrest. This study showed a male preponderance of coronary artery disease. Hyperhomocysteinemia is found to be an important risk factor in patients with younger age presenting with CAD. Conclusion: In this study, we showed that elevated level of homocysteine is significantly associated with CAD risk independent of other risk factors. Positive correlation was established between hyperhomocysteinemia and major traditional risk factors of Coronary artery disease mainly - Dyslipidemia, diabetes, hypertension and obesity and were proved statistically significant.
ABSTRACT
Objective To observe the correlation and clinical significance between serum homocysteine (HCY) level and the severity of coronary heart disease (CHD). Methods A total of 497 hospital-based patients with newly diagnosed coronary heart disease from June 2018 to June 2021 in our hospital were selected as the study subjects. The patients' sociodemographic information, coronary heart disease condition information and HCY level information at diagnosis were collected. The correlation between serum HCY level and the severity of coronary heart disease was analyzed from multiple perspectives. Data were collected and analyzed using SPSS 19.0 statistical software package. Results The average level of HCY in all patients was (20.23±2.18) μmol/L, among which 330 cases exceeded the standard level of HCY and 167 cases did not exceed the standard level. There were statistically significant differences in serum HCY levels among patients with different genders, different ages, different altitudes, and different types of coronary heart disease (P<0.05). The correlation coefficients between HCY level and the severity of CHD in different genders were r1=0.356, and r2 =0.198, P<0.05. The correlation coefficients between HCY level and the severity of CHD in patients of different ages were r1=0.304, r2=0.50, r3=0.217, and r4=0.185, P<0.05. The correlation coefficients between HCY level and the severity of CHD in patients living at different altitudes were r1=0.129, r2=0.369, and r3 =0.473, P<0.05. The correlation coefficients between HCY level and the severity of CHD in patients with different types of CHD was r1=0.137, r2=0.200, and r3=0.205, P<0.05. Logistic multivariate regression analysis showed that serum HCY, altitude, gender and age were independent risk factors for coronary heart disease (P<0.05). Conclusion The correlation between serum HCY level and the severity of CHD is stronger in male patients than in female patients. The correlation between HCY level and the severity of CHD was strongest in patients aged 40-50. Serum HCY level is more strongly correlated with the severity of CHD in patients with high altitude. Serum HCY test can be used to diagnose CHD and evaluate the severity of coronary artery disease.
ABSTRACT
OBJECTIVE@#To observe the expression level of serum homocysteine (Hcy) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism in patients with hematological diseases complicated with coronary heart disease, and analyze the relationship between serum Hcy level, MTHFR gene polymorphism and coronary heart disease.@*METHODS@#The medical records of 80 patients with coronary heart disease who completed treatment of hematological diseases during the period from March 2018 to March 2020 were selected as observation group. In addition, the medical records of 92 patients with hematological diseases who completed treatment in our hospital during the same period were selected as control group. Venous blood samples of the two groups were collected to detect serum Hcy level and MTHFR gene polymorphism. The serum Hcy levels of the two groups with different MTHFR genotypes were compared, and the effects of the above indicators on hematological diseases complicated with coronary heart disease were analyzed.@*RESULTS@#The detection rates of MTHFR gene TT and TC in the observation group were higher than those in the control group, while the distribution frequency of MTHFR genotype CC was lower (P<0.05). The serum Hcy levels of the patients with MTHFR genotype TT and TC in the observation group was higher than the control group (P<0.05). Binary logistic regression analysis showed that MTHFR gene TC/CC genotype serum Hcy overexpression may be influencing factor which induced coronary heart disease in patients with hematological diseases (OR=2.107/OR=1.634, P<0.05). ROC curves showed that the AUC of serum Hcy level of MTHFR gene TC/CC genotype and hematological disease complicated with coronary heart disease were both > 0.8. When MTHFR gene TC reaching the optimal threshold of 22.165 μmol/L, the sensitivity was 0.950 and the specificity was 0.837, While MTHFR gene CC reached the optimal threshold of 19.630 μmol/L, the sensitivity was 0.938 and the specificity was 0.826, the best predictive value could be obtained.@*CONCLUSION@#The changes of serum Hcy and MTHFR gene polymorphisms may be involved in the pathological process in patients with hematological diseases complicated with coronary heart disease. In the future, early detection of serum Hcy levels and MTHFR gene polymorphisms in patients with hematological diseases can be used to predict the risk of coronary heart disease.
Subject(s)
Humans , Coronary Disease/genetics , Genotype , Hematologic Diseases/complications , Homocysteine , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Polymorphism, GeneticABSTRACT
Objective:To investigate the clinical efficacy of risperidone combined with olanzapine in the treatment of first-episode schizophrenia and its effects on serum homocysteine level and cognitive function.Methods:Sixty patients with first-episode schizophrenia who received treatment in Yiwu Mental Health Center from May 2017 to May 2018 were included in this study. They were randomly assigned to receive either olanzapine (control group, n = 30) or olanzapine and risperidone (observation group, n = 30) treatment. All patients received 4 weeks of treatment. We compared serum homocysteine level, cognitive function, and clinical efficacy between the two groups. Results:There was no significant difference in serum homocysteine level pre-treatment between the two groups ( P > 0.05). Serum homocysteine level post-treatment was significantly lower in the observation group than in the control group [(13.59 ± 2.61) mmol/L vs. (15.83 ± 2.58) mmol/L, t = 3.34, P < 0.05). There were no significant differences in the scores of each cognitive function item pre-treatment between the two groups (all P > 0.05). The scores of each cognitive function item post-treatment in the observation group was (15.06 ± 2.28) points, (21.18 ± 3.26) points, (44.39 ± 4.42) points, (40.63 ± 6.27) points, which were significantly superior to those in the control group [(13.31 ± 2.04) points, (19.26 ± 3.07) points, (42.43 ± 2.07) points, (44.19 ± 5.86) points, t = 3.13, 2.34, 2.12, 2.27, all P < 0.05]. The total improvement rate was significantly higher in the observation group than in the control group [93.33% (28/30) vs. 70.00% (21/30), χ2 = 5.45, P < 0.05). Conclusion:Risperidone combined with olanzapine is highly effective on first-episode schizophrenia. The combined therapy can reduce serum homocysteine level and improve cognitive function.
ABSTRACT
Background: According to the WHO, stroke is the second most important cause of death in elderly people with age >60 years and fifth leading cause in the age group of 15 to 59 years. Hyperhomocysteinemia has been linked to increased incidence of ischemic strokes. Thus, the aim of the present study was to assess serum homocysteine levels as an individual risk factor of stroke in young patients.Methods: This was a prospective, cross-sectional, single center study performed in 50 patients admitted in the Department of Medicine, Thanjavur Medical College and Hospital, Thanjavur, over a period of 7 months (i.e., from December 2013 to June 2014). Young patients, aged 1545 years, and diagnosed with stroke were included in the study. Serum homocysteine was measured by fluorescein polarization immunoassay (FPIA). Significant difference between the patients with normal and elevated mean serum homocysteine levels was identified by using unpaired t-test. P value ?0.05 was considered as statistically significant.Results: Majority of the stroke patients were male (78%). Similarly, male patients dominated the total number of patients with elevated serum homocysteine levels (75%). Thirty-two (64%) patients had an elevated serum homocysteine level. There was a significant difference between the patients with increased homocysteine levels as compared to patients with normal homocysteine levels (p value <0.05). Out of 32 patients with hyperhomocysteinemia, 27 (84.38%) patients had ischemic stroke, 4 (12.50%) had cortical vein thrombosis and 1 (3.12%) had hemorrhagic stroke.Conclusions: Findings of the present study confirm that hyperhomocysteinemia is associated with an increased incidence of stroke in young patients. As healthcare providers, we must stress on prevention of stroke, especially by identifying treatable risk factors.
ABSTRACT
Aim & Objective The aim of the study was to evaluate the levels of serum folate and homocysteine in clinical stages of Oral submucous fibrosis (OSF) patients. Methodology The study sample comprised of 40 clinically and histopathologically diagnosed OSF patients those who are not undergoing treatment and 10 healthy controls. OSF was categorised by clinical staging. Serum foliate and homocysteine levels estimation was done by reverse phase high performance liquid chromatography analysis unit and chemiluminescence immuno assay, respectively. Results were statistically analysed using one-way ANOVA [Analysis of variance]. Results Irrespective of age and gender, serum folate deficiency and high levels of homocysteine were noted in OSF patients when compared with healthy controls. Conclusion Serum hyper homocysteinemia and folate deficiency were noted with the progression of the disease. Folate supplements can be given to decrease the levels of homocysteine, to arrest the progression of the disease. However, further longitudinal studies are needed to establish an association between serum homocysteine and serum folate.
ABSTRACT
Objective To investigate the significance of testing serum homocysteine for renal transplant patients .Methods 445 renal transplant patients from outpatient follow‐up(renal transplant group) and 100 healthy subjects(control group) were enrolled in the study ,whose serum homocysteine(Hcy) ,Cystatin C(CysC) ,creatinine(Cr) were tested .Then according to the eGFR(refered to the principle of NKF‐K/DOQI) patients of renal transplant group were divided into six subgroups .Serum levels of Hcy and Cr were compared among different groups ,and the relationship between serum Hcy concentration and anti‐rejection drugs were ana‐lyzed .Results In the transplant group ,concentrations of Hcy were obviously higher than that in control group(P0 .05) . Concentrations of CysC and Cr were significantly associated with Hcy in renal transplant group(r=0 .481 ,0 .456 ,P<0 .05) .There was significant difference between eGFR≥90 subgroup and control group in CysC concentration(P<0 .05) .Conclusion Concen‐tration of Hcy in renal transplant group was obviously higher than that in control group .With the eGFR decreased ,Hcy increased gradually ,and in transplant group was associated with the concentration of CysC and Cr .There was significant difference between eGFR≥90 subgroup and control group in Hcy and CysC concentrations(P<0 .05) .The different anti‐rejection drugs had no effect on serum Hcy levels .
ABSTRACT
Background: Diabetic retinopathy causes vascular complications of retina causing blindness. Macular edema is the crucial cause of visual impairment and may occur at any stage of diabetic retinopathy. Patients suffering from diabetes mellitus can show alterations in their colour perception. Colour vision testing provides a sensitive method to assess macular damage. Deterioration in colour vision often precedes changes in other clinical measures such as visual acuity and morphological changes. Elevated homocysteine levels play a causative role in inducing vascular endothelial cell damage and causing retinopathy in diabetics. Aims & Objective: This observational study was intended to examine if serum homocysteine is a risk factor for developing colour vision defects in diabetes and worsening of retinopathy. Material and Methods: A total of 92 patients with established diabetic retinopathy and having colour vision defects visiting hospital were examined and a detailed history of duration of diabetes was taken. Retinal examination for evidence of diabetic retinopathy and colour vision patterns on Ishihara colour vision chart were noted. OCT was performed on these patients. Results: 92 of patients with diabetic retinopathy under study had a gross colour vision deficiency. The average macular thickness on OCT of patients with total colour vision deficiency was 279 microns. Prevalence of colour vision deficiency increased with duration of diabetes and severity of retinopathy. The average serum homocysteine level in these patients was 21.98 μM/L which was above the normal range. Serum homocysteine levels ranged from 11.0 μM/L to 30.2 among males and 11.1to 41.0 in females. Conclusion: Higher prevalence of colour blindness was observed in patients of diabetes with macular oedema and high circulating serum homocysteine levels. Impaired colour vision was more in patients with average macular thickness of 228 micron and raised homocysteine levels thus suggesting it could be a possible risk factor.
ABSTRACT
Objective: To observe the characteristics of serum homocysteine (Hcy) distribution and the epidemiological characteristics of high serum level of Hcy (HHcy) in Kazakh population. Methods: The stratiifed cluster random sampling method was used to investigate 1003 kazakh individuals in Xinyuan county of Xinjiang including 433 male and 570 female, and they were individuals into 5 age groups:①(25-34) years, n=333,②(35-44) years, n=306, ③(45-54) years, n=230, ④(55-65) years, n=90, ⑤>65 years, n=44. The questionnaire survey, physical check-up and blood biochemical examination were performed and compared among different groups. Results: ① The geometrical mean of Hcy was 13.3μmol/L, and the male was higher than female as 16.0μmol/L vs 11.6μmol/L. ②By age stratiifcation, the serum levels of Hcy elevated with the increased age accordingly. Except for those with the age>65 years, the serum levels of Hcy were all higher in male than female in other 4 age groups. ③The average rate of HHcy prevalence was 31.5%, and the male was higher than female as 49.9%vs 17.5%.④The average rate of H type hypertension prevalence was 35.1%, and the male was higher than female as 44.3%vs 28.1%. There were 87.6%of H type hypertensive patients with H type hypertension, and the male was higher than female as 95.0%vs 80.0%, all P Conclusion: The serum levels of Hcy were different from gender and age; the prevalences of HHcy and H type hypertension were higher in Kazakh population at Xinyuan county of Xinjiang. Community intervention should be conducted to improve the public health condition in Kazakh population.
ABSTRACT
Aims and Objective: Evaluation of C677T polymorphisms of the methylenetetra hydrofolate reductase (MTHFR) gene and its association with level of serum homocysteine, folate, and vitamin B12 as possible maternal risk factors for Down syndrome. Design: This was a case-control study. Material and Methods : Fifty-two mothers (mean age 27.6 years) with babies having free trisomy 21 of North Indian ethnicity and 52 control nonlactating mothers (mean age 24.9 years) of same ethnicity attending services of genetic lab for bloodletting for other causes were enrolled after informed written consent. Fasting blood was collected and was used for determination of plasma homocysteine, vitamin B12, and folate (serum and RBC), and for PCR amplification of the MTHFR gene. Results: The prevalence of MTHFR C677T polymorphism in north Indian mothers of babies with trisomy 21 Down syndrome was 15.38% compared to 5.88 % in controls. The difference between two groups was not statistically significant ( P = 0.124). Low serum folate was demonstrated in 34.62% of cases vs. 11.54% in controls, which was significant ( P = 0.005). Low RBC folate was found in 30.7% of cases versus 11.53% in controls, which was not significant ( P = 0.059), when analyzed independently. But on multiple regression analysis the difference was statistically significant. Low serum vitamin B12 was found in 42.31% of cases versus 34.62% in controls, which was not significant ( P = 0.118). The mean serum homocysteine in cases was 10.35 ± 0.68 while controls were 9.02 ± 0.535. Conclusion: Serum levels of folate were low in cases. The RBC folate levels were comparable in both groups. However the combined serum folate and RBC folate were low in cases compared to control groups. Homocysteine levels in our study were higher in Down syndrome mothers compared to controls; however high-serum level of Homocysteine had no association with MTHFR polymorphism. No association of serum vitamin B12 with MTHFR polymorphism in occurrence of Down syndrome births was found. Peri- or preconceptional folate supplementation may therefore lead to a decline in DS births, if supported by larger studies.
ABSTRACT
Objective To study the relationship between serum homocysteine level and acute type 2 diabetes mellitus complicated with cerebral infarction.Methods Patients were divided into three groups:acute diabetic cerebral infarction group including 87 patients,diabetes mellitus including 72 patients and control group including 67 healthy persons.The HCY,folic acid,VitB12 and serum lipid were determined.The data was analyzed and the relationship was discussed.Results The level of HCY in diabetic cerebral infarction group[(15.7 ±9.7)nmol/L]was much higher than that in the other two groups[(11.9±7.2)nmol/L and(13.5±6.1)nmol/L].Conclusion HCY maybe participate in occurrence and development of diabetes and pathological changes of blood vessels.It was an independent risk factor of acute cerebral infarction.
ABSTRACT
Objective. To assay serum homocysteine levels and examine its association with conventional risk factors for cardiovascular disease (CVD) in Indian adolescents. Methods. This was a cross-sectional study conducted in tertiary care hospital in northern India in apparently healthy adolescents aged 10 – 19 yr. A pre-designed questionnaire was used to assess conventional risk factors. Serum homocysteine levels of ≥ 12μmol/L, serum triglycerides ≥ 150 mg% and serum cholesterol ≥ 200 mg% were taken as hyperhomocysteinemia, hypertriglyceridemia and hypercholesterolemia, respectively. Serum high-density lipoprotein (HDL) ≥ 40 mg% was considered protective for CVD. Results. In 103 subjects, 36.87 % females, mean serum homocysteine level was 11.649 ±0.416μmol/L. Hyperhomocysteinemia was present in 46 (44.6%, 95% CI: 34.965-54.75) subjects. Dietary deficiency of vitamin B12 and folic acid, body mass index (BMI) > 84th percentile and altered lipid profile were associated with hyperhomocysteinemia on univariate analysis. After multivariate adjustment for BMI and vegetarian diet, low serum HDL (OR: 23.81, 95% CI: 2.86-200; p =0.003) and serum hypertriglyceridemia (OR: 4.17, 95% CI: 1.51 – 13.51; p = 0.022) had independent association with hyperhomocysteinemia. Conclusion. Since we have also found an association between hyperhomocysteinemia and low serum HDL levels and hypertriglyceridemia, which are conventional risk factors for CVD, interventional strategies are urgently needed among adolescents for prevention of CVD.
Subject(s)
Adolescent , Age Factors , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/prevention & control , Child , Cross-Sectional Studies , Diet , Enzyme-Linked Immunosorbent Assay , Female , Follow-Up Studies , Health Surveys , Homocysteine/blood , Homocysteine/metabolism , Humans , Hyperhomocysteinemia/diagnosis , Incidence , India/epidemiology , Logistic Models , Male , Mass Screening/methods , Odds Ratio , Probability , Risk Assessment , Sex Factors , Young AdultABSTRACT
Elevated homocysteine concentration is known to be related to placental abruption, spontaneous abortion, and many adverse pregnancy outcomes. The purpose of this study was to investigate the effects of folic acid supplementation (1000 microgram per day) and 5, 10 methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotype on serum homocysteine and B vitamin levels in 50 infertile women (aged 31.2 +/- 3.2 years). Blood sampling was performed at baseline and at the end of folic acid supplementation period. In infertile women, serum folate and vitamin B12 concentrations were significantly higher in post-supplementation than those in pre-supplementation. Serum homocysteine concentration was significantly lower in post-supplementation than that in pre-supplementation. However, serum homocysteine levels were still higher in the T/T genotype than those in the C/C or C/T even after folic acid supplementation. Serum homocysteine was inversely related to serum folate in T/T homozygotes at baseline and at the end of folic acid supplementation. These results suggest that folic acid supplementation is needed for infertile women to improve their vitamin status and also to reduce the risk of hyperhomocysteinemia. These effects were different according to their MTHFR C677T genotypes. Therefore, further studies are necessary to determine the optimal level of supplementation of folic acid by MTHFR genotypes.