Analysis of plasma homocysteine levels in patients with unstable angina.

OBJECTIVE: To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS: We prospectively studied 46 patients (24 females) with unstable angina and 46 control patients (19 males), paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS: Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7+/-6.7 micromol/L) than in the control group (8.7+/-4.4 micromol/L) (p<0.05). Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1+/-5.9 micromol/L versus 11.9+/-4.2 micromol/L). Among females, however, a statistically significant difference was observed between the 2 groups: 11.0+/-7.4 micromol/L versus 6.4+/-2.9 micromol/L (p<0.05) in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 micromol/L. CONCLUSION: High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

Análise dos níveis de homocisteína plasmática em pacientes com angina instável / Analysis of plasma homocysteine levels in patients with unstable angina

OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females) with unstable angina and 46 control patients (19 males), paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 æmol/L) than in the control group (8.7±4.4 æmol/L) (p<0.05). Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 æmol/L versus 11.9±4.2 æmol/L). Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 æmol/L versus 6.4±2.9 æmol/L (p<0.05) in the unstable angina and control groups, respectively. Approximately 24 percent of the patients had unstable angina at homocysteine levels above 15 æmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females

Relationship between total homocysteine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vitamin B12.

OBJECTIVE: To determine total homocysteine and folate levels in pregnant women according to vitamin B12 (B12) levels, and to analyse the impact of maternal B12 levels on the nutritional status of their newborn babies. DESIGN: Cross sectional observational study. SETTING: Two public hospitals in Jundiai City, São Paulo, Brazil. SAMPLE: Sixty-nine pregnant women and their respective newborn babies at the time of delivery. METHODS: Maternal blood was collected up to 8 hours before delivery. Umbilical cord blood was collected after the expulsion of the placenta. Total homocysteine was measured by high perfomance liquid chromatography, folate by ion capture methodology and B12 by enzyme immunoassay. MAIN OUTCOME MEASURES: Relationship between low maternal vitamin B12 levels and total homocysteine and folate levels in pregnant women and newborn babies. RESULTS: There was a significant correlation between maternal and neonatal B12 levels, but not between maternal B12 and neonatal red blood cell (RBC) folate. There was a weak correlation between maternal B12 levels and neonatal serum folate. However, there were significant correlations between maternal and neonatal total homocysteine levels and between neonatal B12 and neonatal total homocysteine levels. Mean (+/- SD) umbilical cord blood B12, RBC folate, serum folate and total homocysteine levels were 1.7 +/- 0.8, 1.8 +/- 0.8, 2.2 +/- 0.8 and 0.9 +/- 0.3 times higher than maternal B12, RBC folate, serum folate and total homocysteine values, respectively. CONCLUSIONS: These data suggest that pregnant women with low B12 levels are unable to provide the necessary amount of B12 to their fetuses. The clinical consequences could be the presence of neurological abnormalities as well as the lack of utilisation of homocysteine for methionine transformation.