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1.
Nutr Metab Cardiovasc Dis ; 31(4): 1276-1285, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33549433

RESUMEN

BACKGROUND AND AIMS: Dual antiplatelet therapy (DAPT) and Renin-angiotensin system inhibitors (RASi) represent the cornerstone in the treatment of patients undergoing percutaneous coronary interventions (PCI), mainly after an acute ischemic event. However, high-on treatment residual platelet reactivity (HRPR), is not infrequent despite optimal medical treatment. Homocysteine (Hcy) is a metabolite of methionine catabolism linked to atherothrombosis. Recently, a potential crosstalk between RAS and Hcy has been suggested, potentially favouring platelet aggregation and cardiovascular disease.Therefore, we aimed to investigate the impact of RASi on Hcy levels and platelet aggregation in patients on DAPT after PCI. METHODS AND RESULTS: Patients undergoing PCI on DAPT with ASA plus an ADP-antagonist (clopidogrel, ticagrelor or prasugrel), were included. RASi comprised angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB). Aggregation tests were performed by Multiple Electrode Aggregometry. We included 1210 patients, of whom 862 (71.2%) were on treatment with RASi. Overall, DAPT composition was ASA+clopidogrel in 566 (46.8%) patients, ASA+ticagrelor in 428 (35.4%) and ASA+prasugrel in 216 (17.9%). Median values of Hcy were higher in RASi patients (p = 0.006), who displayed a higher percentage of Hcy above the median value (52.4% vs. 44.8%, p = 0.019, adjustedOR [95%CI] = 1.40 [1.04-1.88], p = 0.027). No differences in HRPR rate were found according to RASi use for ASPI test (3.6% vs. 3.3%, p = 0.88) and ADP test (25.6% vs. 24.3%,p = 0.62; adjustedOR [95%CI] = 1.23 [0.89-1.70], p = 0.220) and according to ADP-antagonist type. A direct linear relationship was observed between platelet reactivity and Hcy in both patients receiving RASi and untreated ones, with higher values of platelet aggregation being observed in patients with Hcy above the median, independently from RASi administration and DAPT strategy. CONCLUSION: In patients on DAPT after PCI, RASi treatment did not emerge as an independent predictor of HRPR. However, the levels of Hcy were significantly elevated in patients on RASi and related to higher values of platelet reactivity, independently from the DAPT strategy.


Asunto(s)
Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Plaquetas/efectos de los fármacos , Enfermedad de la Arteria Coronaria/terapia , Terapia Antiplaquetaria Doble , Homocisteína/sangre , Intervención Coronaria Percutánea , Agregación Plaquetaria/efectos de los fármacos , Anciano , Antagonistas de Receptores de Angiotensina/efectos adversos , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Biomarcadores/sangre , Plaquetas/metabolismo , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Terapia Antiplaquetaria Doble/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Factores de Tiempo , Resultado del Tratamiento , Regulación hacia Arriba
2.
Isr Med Assoc J ; 23(1): 17-22, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33443337

RESUMEN

BACKGROUND: Low folate levels are associated with megaloblastic anemia, neural tube defects, and an increased risk of cancer. Data are scarce regarding the sex aspect of this deficiency. OBJECTIVES: To assess sex differences in folate levels in a large cohort of patients and to investigate the effect of low folate levels on homocysteine concentrations. METHODS: Data were collected from medical records of patients examined at a screening center in Israel between 2000 and 2014. Cross sectional analysis was conducted on 9214 males and 4336 females. RESULTS: The average age was 48.4 ± 9.5 years for males and 47.6 ± 9.4 years for females. Average folate levels were 19.2 ± 8.6 and 22.4 ±10.3 nmol/L in males and females, respectively (P < 0.001). The prevalence of folate levels below 12.2 nmol/L was 19.5% in males compared to 11.6% in females (P < 0.001). In patients with low folate levels and normal B12 levels, homocysteine levels above 15 µmol/L were found in 32.4% of males and 11.4% of females (P < 0.001). Males had a significantly higher odds ratio (OR) of having folate levels below 12.2 nmol/L: OR 1.84 (95% confidence interval [95%CI] 1.66-2.05) in a non-adjusted model, and OR 2.02 (95%CI 1.82-2.27) adjusted for age, smoking status, body mass index, kidney function, albumin, and triglycerides levels. CONCLUSIONS: Folate levels are lower in males compared to females, which may contribute to the higher homocysteine levels found in males and thus to their increased risk of developing atherosclerosis and coronary artery disease.


Asunto(s)
Ácido Fólico/sangre , Homocisteína/sangre , Deficiencia de Vitamina B 12 , Vitamina B 12/sangre , Estudios Transversales , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores Sexuales , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/diagnóstico , Deficiencia de Vitamina B 12/epidemiología
3.
Artículo en Inglés | MEDLINE | ID: mdl-33406604

RESUMEN

BACKGROUND: A review of epidemiological data demonstrates relationships between defined health behaviours linked with religious affiliation and a reduced risk of developing and dying from Cardiovascular Disease (CVD). The aim of the study was to compare the lifestyle of Seventh-day Adventists (SDA) and Catholics (CA), to determine the relationship between the lifestyle of SDA, CA and the level of serum homocysteine as a risk factor for CVD. METHODS: A cross-sectional study was conducted on 252 SDA and CA. The following tools were used: interview questionnaire, anthropometric measurement, the International Physical Activity Questionnaire (IPAQ), the Inventory of Health Behaviours (IHB), the Perceived Stress Scale (PSS-10), laboratory tests (homocysteine level), and the Fagerström Test for Nicotine Dependence (FTND). RESULTS: Selected lifestyle elements, such as smoking cigarettes, drinking alcohol, physical activity, diet, Body Mass Index (BMI), health behaviours on the IHB, psychosocial factors and level of stress for CA were significantly different in comparison to SDA. The religion professed by the respondents was not significantly associated with the increased level of homocysteine as a risk factor for cardiovascular diseases (CVD). The level of homocysteine for CA were significantly different in comparison to SDA. The studied group of CA was significantly influenced by socio-demographic factors: gender, age, education, place of residence, BMI and lifestyle: drinking alcohol and smoking cigarettes, consumption of dark bread, pasta, and groats. For the studied group of SDA, the level of homocysteine was significantly influenced by socio-demographic factors such as gender, age, professional activity, and consumption of legumes. CONCLUSIONS: Public health professionals and nurses should develop culturally specific educational interventions.


Asunto(s)
Enfermedades Cardiovasculares , Catolicismo , Homocisteína/sangre , Estilo de Vida , Protestantismo , Adulto , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Factores de Riesgo
4.
Medicine (Baltimore) ; 100(2): e24269, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466214

RESUMEN

ABSTRACT: Cystatin C has been proposed as a useful biomarker of early impaired kidney function and a predictor of mortality risk. The present study is to investigate the association between serum Cystatin C and the severity of coronary artery lesions, Gensini score (GS), and the risk of coronary artery disease (CAD).A total of 682 CAD patients (230 females, 452 males; mean age 62.6 ±â€Š10.7 years, range from 31 to 86 years) and 135 controls (41 females, 94 males; mean age 58.0 ±â€Š10.3 years, range from 38 to 84 years) were recruited in the present study. Enzyme-linked immunosorbent assay was applied to measure serum cystatin C levels and other serum indexes. The estimated glomerular filtration rate and GS were calculated.Serum low-density lipoprotein cholesterol (LDL-C), uric acid, Cystatin C, and homocysteine (HCY) were significantly elevated in CAD patients compared to controls. There were significant differences regarding total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, cystatin C, eGFR and GS among stable angina pectoris (SAP), unstable angina group (UAP), and acute myocardial infarction (AMI) patients. AMI group had an elevated serum Cystatin C, LDL-C, HCY, and GS than SAP and UAP patients. When stratified patient groups by the quartiles of Cystatin C, we found age, the proportion of male and patients with diabetes, HCY, and GS were increased in Q4 than in other quartile groups. Spearman correlation test revealed a positive relationship between Cystatin C, HCY, and GS. Multivariate logistic regression analysis revealed that serum Cystatin C level, presence of hypertension and diabetes, HCY, age, and male were the risk factors for coronary artery lesions.In summary, our results suggested that cystatin C is a promising clinical biomarker that provides complementary information to the established risk determinants. The serum Cystatin C level is strongly associated with GS and could be used to evaluate the severity of coronary artery lesions.


Asunto(s)
Enfermedad de la Arteria Coronaria/etiología , Cistatina C/sangre , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Colesterol/sangre , Femenino , Tasa de Filtración Glomerular , Homocisteína/sangre , Humanos , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Triglicéridos/sangre , Ácido Úrico/sangre
5.
J Stroke Cerebrovasc Dis ; 30(3): 105537, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33338706

RESUMEN

BACKGROUND: Intracerebral hemorrhage (ICH) is associated with high mortality, morbidity, and recurrence. Studies have reported the accuracy of several blood biomarkers in predicting clinical outcomes; however, their independent contribution in prediction remains to be established. AIM: To investigate the incremental accuracy in predicting clinical outcomes in patients with ICH in a north Indian population using blood-based biomarkers. METHODS: In this study, a total of 250 ICH cases were recruited within 72 hours of onset. Baseline clinical and CT scan measurement were recorded. Homocysteine (HCY), C-reactive protein (CRP), matrix metalloproteinase-9 (MMP9), E-selectin (SELE), and P-selectin (SELP) levels were measured through ELISA. Telephonic follow-up was done by using mRS scale at three months. RESULTS: The mean age of cohort was 54.9 (SD±12.8) years with 64.8% patients being male. A total of 109 (43.6%) deaths were observed over three months follow-up. Area under the receiver operating characteristics curve-(AUROC) for 90-day mortality were 0.55 (HCY), 0.62 (CRP), 0.57 (MMP9), 0.60 (SELE) and 0.53 (SELP) and for poor outcome at 90-day (mRS: 3-6) were 0.60 (HCY), 0.62 (CRP), 0.54 (MMP9), 0.67 (SELE) and 0.54 (SELP). In multivariable model including age, ICH volume, IVH and GCS at admission, serum SELE (p=0.004) significant for poor outcome with improved AUROC (0.86) and HCY (p=0.04), CRP (p=0.003) & MMP9 (p=0.02) for mortality with least Akaike's Information Criterion-(AIC) (1060.5). CONCLUSIONS: Our findings suggest that the serum SELE is a significant predictor of poor outcome and HCY, CRP & MMP9 for Mortality in patients with ICH in the north Indian population.


Asunto(s)
Proteína C-Reactiva/análisis , Hemorragia Cerebral/sangre , Selectina E/sangre , Homocisteína/sangre , Metaloproteinasa 9 de la Matriz/sangre , Adulto , Anciano , Biomarcadores/sangre , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/mortalidad , Hemorragia Cerebral/cirugía , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
6.
J Stroke Cerebrovasc Dis ; 30(3): 105538, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33341563

RESUMEN

OBJECTS: In this study, we investigated the association between plasma total homocysteine(tHcy) levels and the risk of early hemorrhagic transformation(HT) in patients with acute ischemic stroke(AIS). METHODS: Consecutive hospitalized participants who met the inclusion criteria were enrolled and grouped according to plasma tHcy levels. Participants were divided into a low homocysteine level(L-tHcy) group (<12 µmol/L) and a high homocysteine level group(H-tHcy) (≥ 12 µmol/L). Baseline computed tomography (CT) examination was performed. HT was determined via CT or magnetic resonance imaging within 1 to 3 days after admission. RESULTS: A total of 1858 patients were screened and 1378 patients completed the this study(797 patients in the H-tHcy group and 581 patients in the L-tHcy group). HT incidence was 5.2% (30/581,) in the L-tHcy group and 11.2% (90/797) in the H-tHcy group(P<0.05). Binary logistic regression analysis showed that initial NIHSS score, tHcy levels, treatment with recombinant tissue plasminogen activator thrombolysis, systolic blood pressure on admission, glucose level on admission, smoking status and estimated glomerular filtration rate were independent risk factors for HT. Receiver operating characteristic analysis showed that tHcy level was a moderately sensitive and specific index to predict the incidence of HT, and the optimal cutoff was 16.56 µmol/L (sensitivity 63.3%, specificity 41.3%). CONCLUSION: Our study findings reveal that high plasma tHcy level is one independent risk factor associated with increased risk of early HT in patients with AIS.


Asunto(s)
Homocisteína/sangre , Hemorragias Intracraneales/epidemiología , /sangre , Anciano , Biomarcadores/sangre , China/epidemiología , Estudios Transversales , Femenino , Humanos , Incidencia , Hemorragias Intracraneales/diagnóstico por imagen , /epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Regulación hacia Arriba
7.
J Clin Neurosci ; 82(Pt A): 13-19, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33317721

RESUMEN

The study aimed to investigate the role of serum homocysteine in hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) within 24 h of intravenous (IV) recombinanttissueplasminogenactivator(rt-PA) in acute ischemic stroke (AIS) patients. 236 consecutive AIS patients (169 men, median 65 years old) who underwent to IV rt-PA within 4.5 h of symptom onset were retrospectively recruited and analyzed. The serum homocysteine levels ranged from 4.45 to 67.71 (median 12.05) µmol/L. HT was observed in 28 (11.9%) patients, including 7 (3.0%) sICH patients within 24 h of IV rt-PA. Multiple parameters were compared between HT and non-HT patients as well as sICH and non-sICH patients. The serum homocysteine levels were higher in patients with HT than in those without HT (13.00 vs. 11.70 µmol/L, P = 0.025) and an independent association between serum homocysteine level and HT within 24 h of IV rt-PA was identified via multivariable logistic regression analysis (odds ratio [OR] = 1.103, 95% confidence interval [CI] = 1.021-1.191, P = 0.013). Moreover, serum homocysteine levels were also significantly higher in patients with sICH than in those without sICH (15.19 vs. 11.73 µmol/L, P = 0.005).Our study suggests that serum homocysteine level is an independent predictor for HT within 24 h of IV rt-PA in AIS patients.


Asunto(s)
Fibrinolíticos/efectos adversos , Homocisteína/sangre , Hemorragias Intracraneales/sangre , Activador de Tejido Plasminógeno/efectos adversos , Administración Intravenosa , Anciano , Biomarcadores/sangre , Femenino , Humanos , Hemorragias Intracraneales/inducido químicamente , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Terapia Trombolítica/efectos adversos , Terapia Trombolítica/métodos
8.
J Oleo Sci ; 69(10): 1287-1295, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33028753

RESUMEN

Policosanol, a mixture of long-chain alcohols found in animal and plant waxes, has several biological effects including lipid-lowering that have been extensively studied. However, its bioavailability is low. To investigate the effect of nanoemulsified rice bran wax policosanol (NPOL) on plasma homocysteine, heart and liver histology in hyperlipidemic rats, high-fat diet containing 2.5% cholesterol was used to induce hyperlipidemia in Sprague Dawley rats. The hyperlipidemic rats were treated with NPOL and rice bran wax policosanol (POL) in comparison with normal diet (ND), high-cholesterol diet (HCD) and simvastatin-treated rats. Plasma homocysteine, heart and liver histology, and hepatic mRNA expression of peroxisome proliferator-activated receptor gamma (PPARG) were evaluated. The NPOL group, similar to the simvastatin group, showed reduced plasma homocysteine, preserved heart and liver histology, and down-regulated hepatic PPARG mRNA in comparison to the control group, and was better than the POL group. The results suggest that the modest effect of NPOL on homocysteine and preservation of heart and liver histology could be through the regulation of PPARG expression on a background of increased assimilation of rice bran wax policosanol.


Asunto(s)
Cardiotónicos , Alcoholes Grasos/farmacología , Alcoholes Grasos/uso terapéutico , Hiperlipidemias/metabolismo , Hiperlipidemias/patología , Hígado/metabolismo , Hígado/patología , Miocardio/metabolismo , Miocardio/patología , Oryza/química , PPAR gamma/genética , PPAR gamma/metabolismo , Fitoterapia , Ceras/química , Animales , Dieta Alta en Grasa/efectos adversos , Expresión Génica/efectos de los fármacos , Homocisteína/sangre , Hiperlipidemias/etiología , Masculino , ARN Mensajero/genética , ARN Mensajero/metabolismo , Ratas Sprague-Dawley
9.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(8. Vyp. 2): 17-23, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33016672

RESUMEN

OBJECTIVE: To evaluate the hemostasis of plasma aminothiols in different subtypes of ischemic stroke (IS). MATERIAL AND METHODS: The study included 177 patients, aged 62 (55-68) years, admitted in the first 8-24 hours since IS onset. The pathogenetic subtype of IS was clarified according to the results of clinical and instrumental examination by the Trial of ORG 10172 in Acute Stroke Treatment criteria. Determination of the total plasma aminothiols levels, their reduced forms and redox status was performed using the ultra-efficient Acquity H-Class UPLC liquid chromatograph (Waters, CSHA). RESULTS: Large-artery atherosclerosis was diagnosed in 24.3% patients, cardioembolic stroke in 20.3%, lacunar stroke in 55.4%. Significant differences in total levels of cysteine (Cys), glutathione (Gsh) and homocysteine (Hcy) were identified in patients with different IS subtypes. Patients with large-artery atherosclerosis and lacunar stroke showed the highest level of Hcy, patients with cardioembolic stroke had the lowest levels of Cys and Gsh. CONCLUSION: Total levels of plasma aminothiols are associated with different subtypes of IS.


Asunto(s)
Aterosclerosis , Isquemia Encefálica/complicaciones , Cisteína , Glutatión , Homocisteína , Accidente Cerebrovascular , Anciano , Isquemia Encefálica/sangre , Cisteína/sangre , Glutatión/sangre , Homocisteína/sangre , Humanos , Persona de Mediana Edad , Oxidación-Reducción
10.
BMC Pulm Med ; 20(1): 237, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-32894108

RESUMEN

BACKGROUND: This study aimed to evaluate whether the Homocysteine (Hcy) level was elevated in chronic obstructive pulmonary disease (COPD) patients and its correlation with the occurrence and acute progression of COPD. METHODS: From November 2014 to November 2015, COPD patients were enrolled from Beijing Chao-yang Hospital, and the the biological and clinical data were collected. These patients were tested in the non-acute exacerbation period and the acute exacerbation period, so they were defined as AECOPD group and Non-AECOPD group. Besides, 50 healthy subjects were recruited and defined as control group. Total plasma Hcy levels (antibodies-online, USA) were determined by enzyme-linked immunosorbent assay. Correlation analysis was used to analyze the correlation between serum Hcy level and ventilatory function. Using ROC curve, the diagnostic value of Hcy for the occurrence and acute progression of COPD was explored. RESULTS: In this study, we found that Hcy levels in the Non-AECOPD group or the AECOPD group were significantly higher than those in the control group (P < 0.001). Meanwhile, compared with the Non-AECOPD group, the Hcy level in the AECOPD group was significantly higher (P < 0.001). In addition, according to the classification of GOLD grade, there was significant difference in the Hcy level among different GOLD grade groups (P < 0.001). The correlation analysis showed that in the AECOPD group and the Non-AECOPD group, Hcy levels presented a negative correlation with FEV1(r < 0). Meanwhile, FEV1% was also negatively correlated with Hcy level (r < 0). ROC curve analysis showed that when the cutoff value was set to 10.8 µg/ml, the specificity, sensitivity and AUC were the best, which were 0.980, 0.800, and 0.945, respectively. Besides, our results showed that when the cutoff value was set to 14.0 µg / ml, the specificity, sensitivity and AUC were the best, which were 0.846, 0.680, and 0.802, respectively. In addition, compared with the prediction of acute progression of COPD, when Hcy level predicted the occurrence of COPD, its specificity (0.980 vs. 0.846, P < 0.001) and sensitivity (0.800 vs. 0.680, P < 0.001) were significantly higher. CONCLUSION: Hcy level is positively correlated with the severity of COPD patients, which has predictive value for the occurrence of COPD and acute progression.


Asunto(s)
Progresión de la Enfermedad , Homocisteína/sangre , Enfermedad Pulmonar Obstructiva Crónica/sangre , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Aguda , Anciano , Correlación de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos
11.
BMC Med Genet ; 21(1): 183, 2020 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-32957924

RESUMEN

BACKGROUND: Disorders of the metabolism and absorption of vitamin B12 can lead to decrease in activity of methionine synthetase and methylmalonate coenzyme A mutase (MMUT), which results in increased levels of methylmalonic acid and homocysteine in blood and urine. Often, combined methylmalonic acidemia (MMA) and homocysteinemia is misdiagnosed due to a lack of specific symptoms. The clinical manifestations are diverse, but proteinuria as the initial presentation is rare. CASE PRESENTATION: Two cases of MMA with homocysteinemia in children are reported. Proteinuria were a primary presenting symptom, followed by anemia and neurologic symptoms (frequent convulsions and unstable walking, respectively). Screening of amino acids and acyl carnitine in serum showed that the propionyl carnitine:acetylcarnitine ratio increased. Profiling of urinary organic acids by gas chromatography-mass spectrometry revealed high levels of methylmalonic acid. Homocysteine content in blood was increased. Comprehensive genetic analyses of peripheral blood-derived DNA demonstrated heterozygous variants of methylmalonic aciduria type C and homocystinuria (MMACHC) and amnionless (AMN) genes in our two patients, respectively. After active treatment, the clinical manifestations in Case 1 were relieved and urinary protein ceased to be observed; Case 2 had persistent proteinuria and was lost to follow-up. CONCLUSIONS: Analyses of the organic acids in blood and urine suggested MMA combined with homocysteinemia. In such diseases, reports of renal damage are uncommon and proteinuria as the initial presentation is rare. Molecular analysis indicated two different genetic causes. Although the pathologic mechanisms were related to vitamin B12, the severity and prognosis of renal lesions were different. Therefore, gene detection provides new insights into inherited metabolic diseases.


Asunto(s)
Errores Innatos del Metabolismo de los Aminoácidos/complicaciones , Hiperhomocisteinemia/complicaciones , Proteinuria/diagnóstico , Adolescente , Errores Innatos del Metabolismo de los Aminoácidos/genética , Aminoácidos/sangre , Secuencia de Bases , Carnitina/análogos & derivados , Carnitina/sangre , Preescolar , ADN/sangre , ADN/genética , Cromatografía de Gases y Espectrometría de Masas , Homocisteína/sangre , Humanos , Hiperhomocisteinemia/genética , Masculino , Ácido Metilmalónico/orina , Proteinuria/etiología
12.
J Vet Sci ; 21(4): e47, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32735090

RESUMEN

BACKGROUND: Homocysteine (HCY) was evaluated in healthy and chronic enteropathic dogs, however no studies on dogs with immunosuppressant-responsive enteropathy are available. OBJECTIVES: The aim was to evaluate serum HCY concentrations and its prognostic role in dogs with immunosuppressant-responsive enteropathy compared to healthy dogs. METHODS: Serum HCY concentration was statistically compared between 24 healthy dogs and 29 dogs with immunosuppressant-responsive enteropathy. Correlation analyses between serum total protein, albumin (ALB), C-reactive protein (CRP), folate and cobalamin, and serum HCY concentration were performed in immunosuppressant-responsive enteropathic dogs. RESULTS: The associations between serum HCY concentration and clinical, histological, endoscopic scores and follow-up were evaluated. Mean serum HCY concentration was higher in immunosuppressant-responsive enteropathic dogs compared to control dogs (30.22 ± 8.67 µmol/L vs. 5.26 ± 2.78 µmol/L; p < 0.0001). No association between serum HCY concentration and total protein, ALB, CRP, folate concentration as well as, clinical score, histological and endoscopic scores was found. A negative correlation between serum HCY concentration and cobalamin was noted (p = 0.0025, r = -0.54). No significant difference in HCY was found between responsive and non-responsive dogs or between survivors and non-survivors. CONCLUSIONS: Although, serum HCY concentration was higher in immunosuppressant-responsive enteropathy, its prognostic value remains unclear. However, further prospective, large-scale studies are warranted to better investigate the possible prognostic role of HCY in immunosuppressant-responsive enteropathic dogs.


Asunto(s)
Enfermedades de los Perros/sangre , Enteritis/tratamiento farmacológico , Homocisteína/sangre , Inmunosupresores/administración & dosificación , Animales , Enfermedades de los Perros/diagnóstico , Perros , Enteritis/diagnóstico , Femenino , Masculino , Pronóstico
13.
Medicine (Baltimore) ; 99(34): e21541, 2020 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-32846763

RESUMEN

The influences of hyperhomocysteinemia on cardiovascular diseases (CVDs), stroke and new-onset hypertension are unclear. The aim of the study is to explore the associations of homocysteine levels with stroke, CVDs, and new-onset hypertension in Chinese individuals.This retrospective cohort study included outpatients and inpatients from the Department of Geriatrics at Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine from January to December 2000. They were divided based on their homocysteine (Hcy) levels in 2000: Q1 (<10 µmol/L), Q2 (10-15 µmol/L), and Q3 (>15 µmol/L) and according to whether they had hypertension at baseline. Information about stroke, mortality and major adverse cardiac events, and newly onset hypertension was gathered in December each year until 2017. The effects of Hcy levels on the risk for stroke and CVDs among all patients, and new-onset hypertension among patients without hypertension at baseline were evaluated.After adjustment for confounders, compared with the Q1 group (Hcy <10 µmol/L), when the Hcy increased to 10 to 15 µmol/L, the risks for stroke, CVDs, and new-onset hypertension significantly increased, and the hazard ratio and 95% confidence interval were 2.02 (1.35-3.05, P = .001), 2.22 (1.32-3.76, P = .003), and 7.20 (4.52-11.48, P < .001), respectively. Hcy improved the predictive capability of traditional risk factors for stroke. The optimal cut-off value of Hcy for predicting stroke was 13.4 µmol/L (sensitivity: 70.9%, specificity: 62.2%).Hcy 10 to 15 µmol/L is significantly associated with the risks for stroke, mortality and major adverse cardiac events, and hypertension. The best cut-off point of Hcy for predicting stroke is 13.4 µmol/L.


Asunto(s)
Homocisteína/sangre , Hipertensión/sangre , Accidente Cerebrovascular/sangre , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
14.
Nutr Metab Cardiovasc Dis ; 30(9): 1492-1499, 2020 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-32620336

RESUMEN

BACKGROUND AND AIMS: This study aimed to examine whether intraplaque neovascularization (IPN) of carotid plaques, as characterized by contrast-enhanced ultrasound (CEUS), is associated with atherosclerotic renal artery stenosis (ARAS) in patients with normal kidney function. METHODS AND RESULTS: We investigated carotid IPN using CEUS in 198 consecutive patients with normal kidney function with and without ARAS. IPN was graded on the basis of the presence and location of microbubbles within each plaque (0, no visible microbubbles in the plaque; 1, moderate microbubbles confined to the shoulder and/or adventitial side of the plaque; and 2, extensive microbubbles throughout the plaque). The grades of each plaque were averaged to obtain an overall score per patient. ARAS was determined angiographically. We found that a higher CEUS-assessed carotid IPN score was associated with ARAS (Odd Ratio, OR: 7.281; 95% Confidence Interval, 95% CI: 3.246-16.336; P < 0.001). Furthermore, an IPN score >1.75 predicted severe stenosis with a sensitivity of 81% and specificity of 58%. Compared with using the IPN score alone, the addition of the homocysteine (HCY) cutoff value (>22.5 mmol/L) resulted in a stronger predictive value (Area Under Curve, AUC: 0.893 vs 0.834; P < 0.001) for severe ARAS. CONCLUSION: Carotid plaque neovascularization combined with HCY levels is predictive of severe ARAS in patients with normal kidney function. CEUS-assessed carotid IPN is clinically useful for stratification of ARAS in patients with normal kidney function.


Asunto(s)
Arterias Carótidas/diagnóstico por imagen , Estenosis Carotídea/diagnóstico por imagen , Neovascularización Patológica , Placa Aterosclerótica , Obstrucción de la Arteria Renal/diagnóstico por imagen , Arteria Renal/diagnóstico por imagen , Ultrasonografía , Anciano , Biomarcadores/sangre , Estenosis Carotídea/sangre , Estenosis Carotídea/epidemiología , Estenosis Carotídea/terapia , China/epidemiología , Medios de Contraste/administración & dosificación , Femenino , Homocisteína/sangre , Humanos , Masculino , Microburbujas , Persona de Mediana Edad , Admisión del Paciente , Valor Predictivo de las Pruebas , Prevalencia , Obstrucción de la Arteria Renal/sangre , Obstrucción de la Arteria Renal/epidemiología , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad
16.
Stroke ; 51(8): 2472-2479, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32640948

RESUMEN

BACKGROUND AND PURPOSE: The cause of moyamoya disease (MMD) remains unknown. We aimed to investigate the association between modifiable risk factors and MMD in a prospective, case-control study. METHODS: Clinical and laboratory characteristics were evaluated in consecutively recruited adult patients with MMD and age-matched healthy control individuals. The potential risk factors for MMD were estimated by logistic regression analysis. RESULTS: Our prospective study included 138 adult patients and 138 healthy control subjects. Logistic regression analyses showed that increased body mass index (odds ratio [OR], 1.121 [95% CI, 1.018-1.234]; P=0.020) and homocysteine (OR, 1.201 [95% CI, 1.081-1.334]; P=0.001) were associated with higher risk of MMD. Whereas increased albumin (OR, 1.043 [95% CI, 1.004-1.082]; P=0.028) and high-density lipoprotein cholesterol (OR, 1.043 [95% CI, 1.004-1.082]; P=0.028) were correlated with a lower risk of MMD. Furthermore, homocysteine (OR, 1.070 [95% CI, 1.010-1.134]; P=0.023) was significantly related to unilateral lesions. CONCLUSIONS: Increased body mass index and homocysteine were associated with a higher risk of MMD. In contrast, increased albumin and high-density lipoprotein cholesterol were correlated with a lower risk of MMD. Furthermore, increased homocysteine was related to a higher prevalence of unilateral MMD. More attention should be paid to the modifiable risk factors of MMD, as these might help us finding its cause and new therapeutic regimen. Registration: URL: http://www.chictr.org. Unique identifier: ChiCTR2000031412.


Asunto(s)
Índice de Masa Corporal , Homocisteína/sangre , Enfermedad de Moyamoya/sangre , Enfermedad de Moyamoya/diagnóstico , Adulto , Biomarcadores , Estudios de Casos y Controles , HDL-Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
17.
Medicine (Baltimore) ; 99(27): e20737, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32629650

RESUMEN

We aimed to investigate the relationship between total homocysteine (tHcy) levels in the plasma and renal function severity in patients with type 2 diabetes mellitus (T2DM) aged ≥75 years.We included 221 patients with T2DM aged ≥60 years (59 aged ≥75 years).tHcy levels among the 4 groups of patients aged ≥60 years significantly differed, but not in those aged ≥75 years. tHcy levels in patients aged ≥60 years were negatively correlated with the estimated glomerular filtration rate. The area under the receiver operating characteristic curve of tHcy for predicting diabetic kidney disease (DKD) was 0.636. Fasting c-peptide and creatinine were independently associated with tHcy levels in patients aged ≥60 years, whereas insulin and creatinine were independently associated with tHcy levels in those aged ≥75 years.tHcy concentrations were elevated in T2DM and can potentially serve as a risk factor for DKD, but it is not an ideal biomarker.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Nefropatías Diabéticas/sangre , Homocisteína/sangre , Factores de Edad , Anciano , Diabetes Mellitus Tipo 2/sangre , Nefropatías Diabéticas/fisiopatología , Femenino , Tasa de Filtración Glomerular , Humanos , Riñón/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad
18.
J Stroke Cerebrovasc Dis ; 29(8): 104925, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32689606

RESUMEN

BACKGROUND: Ischemic stroke is related to the level of total homocysteine and the stability of carotid atherosclerotic plaque. In this study, the characteristics of carotid plaque in hypertensive patients with hyperhomocysteinemia were preliminarily studied by conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification. METHODS: Hypertensive patients (n=196) hospitalised in the Department of Neurology and Cardiology of our hospital from April 2016 to February 2019 were studied to compare and analyse differences in general clinical data, conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification between hypertension with hyperhomocysteinemia and hypertension with normal tHcy. RESULTS: 1. There was no statistical difference in other clinical data, except fasting blood sugar (P=0.021) and the history of cerebral infarction (P=0.0001). 2. There were significant differences in plaque thickness, stenosis degree, contrast-enhanced ultrasound level, The maximum shear wave velocity (SWVmax) , the minimum shear wave velocity (SWVmin) and the mean shear wave velocity (SWVmean) (P<0.05), except intima-media thickness between the two groups (t=0.160, P=0.873). 3. Blood tHcy level in hypertensive patients with hyperhomocysteinemia was positively correlated with carotid plaque thickness, stenosis degree and contrast-enhanced ultrasound level (r=0.349, 0.647, 0.421), but negatively correlated with SWVmax, SWVmin and SWVmean (r=-0.348, -0.409, -0.393). CONCLUSIONS: Ultrasonography can reflect the vulnerability of hypertensive patients with hyperhomocysteinemia, providing reliable and comprehensive information for the prevention and treatment of stroke in hypertensive patients with hyperhomocysteinemia.


Asunto(s)
Grosor Intima-Media Carotídeo , Estenosis Carotídea/diagnóstico por imagen , Hiperhomocisteinemia/complicaciones , Hipertensión/complicaciones , Placa Aterosclerótica , Anciano , Biomarcadores/sangre , Presión Sanguínea , Estenosis Carotídea/etiología , Femenino , Homocisteína/sangre , Humanos , Hiperhomocisteinemia/sangre , Hiperhomocisteinemia/diagnóstico , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Factores de Riesgo , Índice de Severidad de la Enfermedad
19.
Nutr Metab Cardiovasc Dis ; 30(8): 1281-1288, 2020 07 24.
Artículo en Inglés | MEDLINE | ID: mdl-32522470

RESUMEN

BACKGROUND AND AIMS: In Portugal, The Azores Archipelago has the highest standardized mortality rate for CAD. Therefore, the aim of this study was to evaluate conventional risk factors, as well as plasma and erythrocyte aminothiol concentration in high-risk Azorean patients undergoing elective coronary angiography and to investigate whether any aminothiol was associated with CAD risk and severity. METHODS AND RESULTS: 174 subjects with symptomatic CAD (age 56±9y; 68% men) submitted to coronary angiography were split into 2 groups: one formed by CAD patients (≥50% stenosis in at least one major coronary vessel) and the other by non-CAD patients (<50% stenosis). Both groups were age-, sex- and BMI-matched. Plasma and erythrocyte aminothiol profiles were evaluated by RP-HPLC/FLD. CAD patients significantly exhibited both higher concentrations of plasma Cys and hypercysteinemia (Cys ≥ 300 µM) prevalence than those in the non-CAD group (261 ± 58 µM vs. 243 ± 56 µM; 22% vs. 10%, respectively). No differences were observed between groups regarding plasma Hcy levels or hyperhomocysteinemia prevalence. After adjustment for several confounders (including Hcy), subjects in the highest quartile of plasma Cys had a 3.31 (95% CI, 1.32-8.30, p = 0.011) fold risk for CAD, compared with those in the lowest quartiles. Furthermore, plasma Cys levels (but not Hcy) tended to increase with the number of stenotic vessels (1VD: 253 ± 64 µM; 2VD: 262 ± 52 µM; 3VD: 279 ± 57 µM, p = 0.129). CONCLUSION: Hypercysteinemia revealed to be a better predictor of CAD than hyperhomocysteinemia. Moreover, plasma Cys showed to be a useful biomarker for CAD both in primary and secondary preventions, seeming to resist better than Hcy to oral medication therapy.


Asunto(s)
Enfermedad de la Arteria Coronaria/sangre , Estenosis Coronaria/sangre , Cisteína/sangre , Homocisteína/sangre , Hiperhomocisteinemia/sangre , Adulto , Anciano , Biomarcadores/sangre , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/prevención & control , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/epidemiología , Femenino , Humanos , Hiperhomocisteinemia/diagnóstico , Hiperhomocisteinemia/tratamiento farmacológico , Hiperhomocisteinemia/epidemiología , Masculino , Persona de Mediana Edad , Portugal/epidemiología , Valor Predictivo de las Pruebas , Prevalencia , Prevención Primaria , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Prevención Secundaria , Índice de Severidad de la Enfermedad
20.
Medicine (Baltimore) ; 99(26): e20791, 2020 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-32590761

RESUMEN

BACKGROUND: According to the relevant reports that single nucleotide polymorphisms (SNPs) may contribute to change of homocysteine (HCY) levels and increase the risk of hypertension (HTN). During the inconsistent results, this meta-analysis purpose is systematically review and synthesized relevant data on HCY levels and SNPs in HTN. METHODS: The systematic search database, from the following database to find out the association studies of SNPs and HTN publications up until March 2020 from the databases of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM). Network meta-analysis and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. All statistical analyses were calculated with STATA software (version 14.0; StataCorp, College Station, TX). RESULTS: This meta-analysis will provide high-quality evidence to the effects of SNP on HTN and levels of HCY, and find between SNPs and HTN susceptibility on in all the genetic models, and choose the best one. CONCLUSIONS: This meta-analysis will research which SNP is the most correlated with HTN risk. REGISTRATION: INPLASY202050002.


Asunto(s)
Predisposición Genética a la Enfermedad , Homocisteína , Hipertensión , Correlación de Datos , Homocisteína/sangre , Homocisteína/genética , Humanos , Hipertensión/sangre , Hipertensión/diagnóstico , Hipertensión/genética , Metaanálisis en Red , Polimorfismo de Nucleótido Simple , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
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