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1.
Medicine (Baltimore) ; 98(39): e17334, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574870

RESUMO

RATIONALE: Subacute combined degeneration (SCD) is a disease caused by decreased vitamin B12 intake or metabolic disorders. It is more common in the elderly and rarely seen in children. Here, we report 2 pediatric cases of SCD in late-onset cobalamin C (CblC) deficiency. PATIENT CONCERNS: The patients complained of unsteady gait. Their physical examination showed sensory ataxia. Magnetic resonance imaging showed classic manifestations of SCD. The serum vitamin B12 level was normal, but urine methylmalonic acid and serum homocysteine levels were high. DIAGNOSIS: The pathogenic gene was confirmed as MMACHC. The 2 patients each had 2 pathogenic mutations C.482 G>A and C.271dupA and C.365A>T and C.609G>A in this gene. They were diagnosed with combined methylmalonic acidemia and homocysteinemia-CblC subtype. INTERVENTIONS: The patients were treated with methylcobalamin 500 µg intravenous injection daily after being admitted. After the diagnosis, levocarnitine, betaine, and vitamin B12 were added to the treatment. OUTCOMES: Twelve days after treatment, the boy could walk normally, and his tendon reflex and sense of position returned to normal. The abnormal gait seemed to have become permanent in the girl and she walked with her legs raised higher than normal. LESSONS: To the best of our knowledge, this is the first report of 2 cases of isolated SCD in children with late-onset CblC disorder. Doctors should consider that SCD could be an isolated symptom of CblC disorder. The earlier the treatment, the lower the likelihood of sequelae.


Assuntos
Proteínas de Transporte/genética , Homocistinúria , Degeneração Combinada Subaguda , Deficiência de Vitamina B 12/congênito , Vitamina B 12/análogos & derivados , Adolescente , Ataxia/diagnóstico , Ataxia/etiologia , Ataxia/terapia , Encéfalo/diagnóstico por imagem , Criança , Feminino , Homocisteína/sangue , Homocistinúria/diagnóstico , Homocistinúria/genética , Humanos , Injeções Intravenosas , Transtornos de Início Tardio , Imagem por Ressonância Magnética/métodos , Masculino , Ácido Metilmalônico/urina , Mutação , Degeneração Combinada Subaguda/diagnóstico , Degeneração Combinada Subaguda/etiologia , Degeneração Combinada Subaguda/fisiopatologia , Degeneração Combinada Subaguda/terapia , Resultado do Tratamento , Vitamina B 12/administração & dosagem , Vitamina B 12/sangue , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/genética , Complexo Vitamínico B/administração & dosagem
2.
Medicine (Baltimore) ; 98(39): e17373, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574886

RESUMO

Ionizing radiation can induce deoxyribonucleic acid (DNA) methylation pattern change, and ionizing radiation-induced oxidative damage may also affect DNA methylation status. However, the influence of low-dose ionizing radiation, such as occupational radiation exposure, on DNA methylation is still controversial.By investigating the relationship between occupational radiation exposure and DNA methylation changes, we evaluated whether radiation-induced oxidative damage was related to DNA methylation alterations and then determined the relationship among occupational radiation level, DNA methylation status, and oxidative damage in interventional physicians.The study population included 117 interventional physicians and 117 controls. We measured global methylation levels of peripheral blood leukocyte DNA and expression level of DNA methyltransferase (Dnmts) and homocysteine (Hcy) in serum to assess the DNA methylation status of the body. We measured 8-hydroxy-2'-deoxyguanosine (8-OHDG) and 4-hydroxynonenal (4-HNE) levels as indices of oxidative damage. Relevance analysis between multiple indices can reflect the relationship among occupational radiation exposure, DNA methylation changes, and oxidative damage in interventional physicians.The expression levels of Dnmts, 4-HNE, and 8-OHDG in interventional physicians were higher than those in controls, while there was no statistical difference in total DNA methylation rate and expression of Hcy between interventional physicians and controls. Total cumulative personal dose equivalent in interventional physicians was positively correlated with the expression levels of Dnmts, 8-OHDG, and 4-HNE. The expression levels of 8-OHDG in interventional physicians were negatively correlated with global DNA methylation levels and positively correlated with the expression levels of Hcy.Occupational radiation exposure of interventional physicians has a certain effect on the expression of related enzymes in the process of DNA methylation, while ionizing radiation-induced oxidative damage also has a certain effect on DNA methylation. However, there was no evidence that dose burden of occupational exposure was associated to changes of DNA methylation status of interventional physicians, since it is rather unclear which differences are observed among the effects produced by radiation exposure and oxidative damage.


Assuntos
Dano ao DNA/efeitos da radiação , Metilação de DNA/efeitos da radiação , Exposição Ocupacional/análise , Estresse Oxidativo/efeitos da radiação , Exposição à Radiação/análise , Radiologia Intervencionista/estatística & dados numéricos , Adulto , Aldeídos/sangue , Desoxiguanosina/análogos & derivados , Desoxiguanosina/sangue , Feminino , Homocisteína/sangue , Humanos , Leucócitos/metabolismo , Masculino , Metiltransferases/sangue , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Médicos/estatística & dados numéricos , Exposição à Radiação/efeitos adversos
3.
Klin Lab Diagn ; 64(9): 516-524, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31610102

RESUMO

The level of homoarginine (hArg) in terms of prognostic significance may exceed the natriuretic peptides and other well-known markers according to the latest data about the progression of cardiovascular diseases. The lack of data on the association of hArg levels with levels of other metabolites makes it difficult to understand its role in the pathogenesis of cardiovascular diseases. Relationships of hArg and other amino acids, including methionine (Met) and total homocysteine (tHcy), and their ratio in patients with ischemic heart disease were evaluated. The study included 74 patients with coronary heart disease (57 men and 17 women) aged 62 (57 - 67) years before coronary artery bypass surgery and 27 healthy people of similar age. In patients, the level of hArg was almost 2 times lower (p < 0.05) than in healthy individuals and rates lower than 1.4 µM were in half of them. The statistically significant decrease (p = 0.0025) of the Met/tHcy ratio corresponded to a decrease in the level of hArg. This ratio did not correlate with glucose level or body mass index. Less statistical significance of hArg correlation with levels of Met or tHcy separately was observed. In the subgroup of patients with hAarg level above 2.1 µM, a lower incidence of myocardial infarction was noted. Thus, a low hArg level is associated with impaired metabolism of sulfur-containing amino acids involved in transmethylation reactions, in patients with ischemic heart disease. The Met/tHcy ratio, closely correlating with the level of hArg, apparently reveals a link between the reactions of creatine formation and transmethylation, highlighting a cohort of patients with the most profound and dangerous changes in tissue metabolism.


Assuntos
Homoarginina/sangue , Homocisteína/sangue , Metionina/sangue , Isquemia Miocárdica/diagnóstico , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Ann Hematol ; 98(10): 2257-2265, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31440871

RESUMO

Vascular complications of sickle cell anemia (SCA) are influenced by many factors. Elevated plasma homocysteine (Hcy) is supposed to be an independent risk factor and is either genetic or nutritional origin. The present study evaluated the plasma Hcy level, MTHFR C677T gene polymorphism, effect of folic acid (FA) supplementation' and hemato-biochemical parameters in SCA and their effect on the vaso-occlusive crisis (VOC) in SCA patients of an Asian-Indian haplotype population. One hundred twenty cases of SCA (HbSS) and 50 controls with normal hemoglobin(HbAA) were studied. It was found that the plasma Hcy level is significantly higher (p < 0.0001) in patients with SCA (22.41 ± 7.8 µmol/L) compared to controls (13.2 ± 4.4 µmol/L). Moreover, patients without FA supplementation had a significantly (p < 0.001) higher Hcy level (27 ± 7 µmol/L) compared to those with supplementation (17.75 ± 5.7 µmol/L). Turkey-Kramer multiple comparison tests show that there is a significant difference (p < 0.05) in HbF percent, hemoglobin (Hb), platelet count, serum bilirubin (direct:Bil-D and total:Bil-T), aspartate transaminase (AST), lactate dehydrogenase (LDH), and plasma Hcy levels between mild and severe VOC. Between moderate VOC and severe VOC, there was a significant difference (p < 0.05) in HbF%, Bil-D, AST, Hcy. Pearson correlation revealed that plasma Hcy had a significantly (p < 0.05) positive correlation with AST, serum bilirubin (indirect and total), LDH, jaundice, stroke, VOC per year, and hospitalization per year whereas it was inversely correlated with HbF percentage, Hb level, and FA treatment. In the study population, increased plasma Hcy level, hemolysis, and platelet activation were found to influence VOC in SCA.


Assuntos
Anemia Falciforme , Homocisteína/sangue , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Polimorfismo Genético , Doenças Vasculares , Adolescente , Adulto , Anemia Falciforme/sangue , Anemia Falciforme/complicações , Anemia Falciforme/genética , Anemia Falciforme/fisiopatologia , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Plaquetas/metabolismo , Feminino , Hemoglobina Fetal/genética , Hemoglobina Fetal/metabolismo , Hemólise , Homocisteína/genética , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/sangue , Pessoa de Meia-Idade , Ativação Plaquetária , Contagem de Plaquetas , Doenças Vasculares/sangue , Doenças Vasculares/etiologia , Doenças Vasculares/genética , Doenças Vasculares/fisiopatologia
5.
Medicine (Baltimore) ; 98(31): e16539, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374015

RESUMO

BACKGROUND: Chronic stable angina (CSA) is a cardiovascular disease with high prevalence. At present, drug treatment is still the main measure of stable angina pectoris. Traditional Chinese medicine has a long history in the treatment of CSA. Qi stagnation and Blood stasis syndrome is a common syndrome of CSA. Xinnaoning (XNN) capsule is considered as an effective adjuvant treatment for CSA with the efficacy of promoting qi and blood circulation but lack of high-quality clinical evidence. The purpose of this study is to evaluate the efficacy and safety of XNN capsule compared with placebo by clinical trial. METHODS: This multicenter, randomized, double-blind, placebo-controlled trial will be conducted with a total of 240 participants diagnosed with chronic stable angina (qi stagnation and blood stasis syndrome). The participants will be randomized (1:1) into groups receiving either XNN or placebo for 12 weeks. After a 2-week run-in period, they will receive either XNN or placebo (3 pills, 3 times daily) for 12 weeks on the basis of conventional therapy. The primary outcomes include changes in the integral scores of angina symptoms. The secondary outcome measures include changes in the total score of traditional Chinese medicine syndrome, severity grading of angina pectoris, the number of angina pectoris per week, nitroglycerin dosage, score of seattle angina scale, serum homocysteine, incidence of cardiovascular events. Safety outcomes will also be assessed. Adverse events will be monitored throughout the trial. RESULTS: This study will investigate whether XNN capsule can alleviate clinical symptoms, and improve quality of life of patients with chronic stable angina (qi stagnation and blood stasis syndrome). The results of this study will provide clinical evidence for the application of XNN capsule in the treatment of chronic stable angina. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03914131.


Assuntos
Angina Estável/terapia , Adulto , Idoso , Análise de Variância , Distribuição de Qui-Quadrado , Angiografia Coronária/métodos , Método Duplo-Cego , Feminino , Homocisteína/análise , Homocisteína/sangue , Humanos , Masculino , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/normas , Pessoa de Meia-Idade , Placebos , Inquéritos e Questionários , Resultado do Tratamento
6.
Georgian Med News ; (290): 25-29, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31322509

RESUMO

There are controversial opinions regarding the impact of hyperhomocysteinemia (HHcy) and insulin resistance in PCOS patients who experience Recurrent Pregnancy Loss (RPL). Nowadays the correlation between levels of anti-müllerian hormone (AMH), homocysteine and insulin resistance (IR) have become the main subject of interest in PCOS patients for predicting RPL. Objective - investigate the relationship between level of homocysteine, anti-müllerian hormone and insulin resistance in PCOS patients with Recurrent Pregnancy Loss. 80 Georgian young women (<30 years) with PCOS were involved in the prospective study. The diagnosis of PCOS was based on the criteria of Rotterdam Consensus 2003. Patients were divided into two groups: group I-50 patients, who experienced RPL, and group II-30 patients with live births in anamnesis (control group). Patients with RPL were divided into two subgroups: subgroup A-with insulin resistance (n=28), and subgroup B-without insulin resistance (n=22). All patients underwent hormonal investigation from day 2 to 3 of menstrual cycle. Plasma levels of anti-müllerian hormone, homocysteine, follicle-stimulating hormone, luteinizing hormone (LH), total testosterone (T), free testosterone (FT), sex hormone binding globulin (SHBG) were determined. Between 2-3 days of the menstrual cycle all participants underwent an ultrasound examination using Voluson E10. This was done to determine ovarian volume and antral follicle count. Average homocysteine (Hcy) level in PCOS patients with RPL (11.5±2.24µmol/l) was significantly higher than in controls (7.55±2.45 µmol/l, p<0.001). Incidence of (HHcy) and IR in patients with RPL was 70% and 56% respectively, which was significantly higher than in controls (HHcy-54.3%; IR- 9.4%; p<0.0001). HOMA-IR in patients with RPL was significantly higher compared with controls (p<0.001). Average AMH level in patients with RPL and live births did not differ significantly. In the group of PCOS with RPL significant positive correlation between Hcy and HOMA-IR, BMI, AMH and FT levels was found (p<0.001). Serum homocysteine level is elevated in PCOS patients with RPL. This elevation is correlated with the degree of obesity, BMI, Insulin Resistance status, AMH and androgen levels. The treatment of hyperhomocysteinemia and insulin resistance in women with PCOS might become the bases for prevention of pregnancy losses and improving reproductive outcomes.


Assuntos
Aborto Habitual/etiologia , Hormônio Antimülleriano/sangue , Homocisteína/sangue , Resistência à Insulina , Síndrome do Ovário Policístico/sangue , Aborto Habitual/sangue , Aborto Habitual/epidemiologia , Adulto , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/metabolismo , Gravidez , Estudos Prospectivos , Testosterona/sangue
7.
Medicine (Baltimore) ; 98(27): e16085, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277103

RESUMO

Studies on hypertension (HTN) in Tibetans who live in high altitude areas are less and whether total homocysteine level (tHcy) is associated with blood pressure (BP) levels or HTN status in Tibetans is unknown.A total of 1486 Tibetans with complete information from a cross-sectional survey conducted in Lhasa Chengguan County of Tibet were included in this study. Demographic data, self-reported history of disease, and life styles were collected using a questionnaire. Blood tHcy, creatinine, fasting plasma-glucose, total cholesterol, triglycerides, and BP were measured with equipment.The median tHcy level of the whole population was 14.60 (13.17-16.50) µmol/L, and the prevalence of HTN was 26.99%. Regression models, adjusted for possible covariates, showed that an average increase of 1 lnHcy (log transformation of tHcy level) was associated with an increase of 3.78 mmHg of systolic BP (SBP, P = .011) and 3.02 mmHg of diastolic BP (DBP, P = .003). The prevalence of HTN, levels of SBP and DBP in the third (OR for HTN: 1.60, P = .026; ß for SBP: 3.41, P = .004; ß for DBP: 2.57, P = .002) and fourth (OR for HTN: 2.19, P < .001; ß for SBP: 5.08, P < .001; ß for DBP: 3.09, P < .001) quartile of tHcy level were higher than those in the first quartile.THcy is associated with BP levels and HTN status among Tibetans. Both HTN management and tHcy level should be paid more attention in Tibetans.


Assuntos
Homocisteína/sangue , Hipertensão/epidemiologia , Adulto , Altitude , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/sangue , Masculino , Pessoa de Meia-Idade , Autorrelato , Tibet/epidemiologia
8.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 35(3): 193-198, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31257797

RESUMO

OBJECTIVE: To investigate the vascular damage effects and possible mechanism of acute exposure to ozone (O3) in male Wistar rats. METHODS: One hundred and twenty male Wistar rats were randomly divided into six groups, 20 in each group. The experimental animals were placed in a gas poisoning cabinet, the control group was exposed to filtered air, and the treatment group was exposed to ozone at concentrations of 0.12 ppm, 0.5 ppm, 1.0 ppm, 2.0 ppm, and 4.0 ppm, respectively, for 4 hours. Arterial blood pressure data were obtained by PC-lab medical physiological signal acquisition system. Blood rheology indicators and blood biochemical indicators were detected by Tianjin Dean Diagnostic Laboratory. Serum endothelin-1 (ET-1), homocysteine (HCY), von Willebrand factor (vWF), 8-hydroxydeoxyguanosine (8-OhdG), interleukin (IL-6) and tumor necrosis factor alpha (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA) microplate assay. Oxidative stress indicators superoxide dismutase (SOD) activity and malondialdehyde (MDA) were determined by xanthine oxidase method, thiobarbituric acid (TBA) method, reduced glutathione (GSH) and nitric oxide (NO) were tested by using microplate colorimetry. Paraffin sections were prepared from thoracic aorta tissue, and vascular structure was observed by HE staining. RESULTS: Acute exposure to 0.12 ppm ozone could cause a significant increase in arterial systolic blood pressure (SBP). Exposure to different concentrations of ozone could cause a significant increase in plasma viscosity, and the K value of the ESR equation was significantly increased in the 1.0 ppm ozone exposure group. Both the relative and reduced viscosities were significantly reduced at ozone concentrations of 0.5 ppm and 4.0 ppm, while the red blood cell deformation index was increased significantly at ozone concentrations of 0.12 ppm, 0.5 ppm, 1.0 ppm, and 2.0 ppm. Acute ozone exposure resulted in the decrease of total cholesterol content. The content of high-density lipoprotein cholesterol (HDL-C) was significantly reduced in the 0.12 ppm ozone exposure group. When the ozone concentration was higher than 1.0 ppm, the body may also had an inflammatory reaction (increased TNF-α) and oxidative stress (increased MDA, decreased GSH). Acute exposure to ozone could lead to elevated levels of ET-1 in the blood, with significant differences in the 4.0 ppm concentration group, while HCY levels were decreased firstly and then increased, reaching the highest in the 1.0 ppm concentration group. No obvious pathological changes were observed in the thoracic aorta. CONCLUSION: Acute ozone exposure can affect arterial blood pressure, blood rheology and cholesterol metabolism in rats. The possible mechanism is that ozone exposure leads to inflammatory reaction and oxidative stress reaction, causing vascular endothelial function damage, and vascular endothelial cells increase with ozone exposure concentration.


Assuntos
Vasos Sanguíneos/lesões , Estresse Oxidativo , Ozônio/toxicidade , Animais , Desoxiguanosina/análogos & derivados , Desoxiguanosina/sangue , Endotelina-1/sangue , Homocisteína/sangue , Interleucina-6/sangue , Masculino , Malondialdeído/análise , Ratos , Ratos Wistar , Superóxido Dismutase/análise , Fator de Necrose Tumoral alfa/sangue , Fator de von Willebrand/análise
9.
Rom J Ophthalmol ; 63(2): 188-192, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31334400

RESUMO

Purpose: To report a case with monocular transient vision loss (TVL) associated with Hyperhomocysteinemia. Methods: We present a case with persistent TVL attacks and high level of homocysteine. Results: A 32-year-old male had a history of episodes of recurrent monocular TVL. Extensive ophthalmic, systemic and laboratory studies were unremarkable with the exception of high plasma homocysteine level. He never experienced TVL during the 36-month follow-up after starting folate, B12 and B6 except for one episode in which he had discontinued the treatment for three months. Conclusion: This case may suggest hyperhomocysteinemia as one of the underlying causes of recurrent attacks of TVL without any known source of emboli.


Assuntos
Amaurose Fugaz/etiologia , Encéfalo/patologia , Homocisteína/sangue , Hiper-Homocisteinemia/complicações , Acuidade Visual , Adulto , Amaurose Fugaz/diagnóstico , Amaurose Fugaz/fisiopatologia , Biomarcadores/sangue , Humanos , Hiper-Homocisteinemia/sangue , Hiper-Homocisteinemia/diagnóstico , Embolia Intracraniana , Imagem por Ressonância Magnética , Masculino , Artéria Oftálmica/diagnóstico por imagem , Recidiva , Ultrassonografia Doppler em Cores
10.
Genomics Proteomics Bioinformatics ; 17(2): 183-189, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31233833

RESUMO

Major depressive disorder (MDD) is the most common nonfatal disease burden worldwide. Systemic chronic low-grade inflammation has been reported to be associated with MDD progression by affecting monoaminergic and glutamatergic neurotransmission. However, whether various proinflammatory cytokines are abnormally elevated before the first episode of depression is still largely unclear. Here, we evaluated 184 adolescent patients who were experiencing their first episode of depressive disorder, and the same number of healthy individuals was included as controls. We tested the serum levels of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), IgE, 14 different types of food antigen-specific IgG, histamine, homocysteine, S100 calcium-binding protein B, and diamine oxidase. We were not able to find any significant differences in the serum levels of hs-CRP or TNF-α between the two groups. However, the histamine level of the patients (12.35 µM) was significantly higher than that of the controls (9.73 µM, P < 0.001, Mann-Whitney U test). Moreover, significantly higher serum food antigen-specific IgG positive rates were also found in the patient group. Furthermore, over 80% of patients exhibited prolonged food intolerance with elevated levels of serum histamine, leading to hyperpermeability of the blood-brain barrier, which has previously been implicated in the pathogenesis of MDD. Hence, prolonged high levels of serum histamine could be a risk factor for depressive disorders, and antihistamine release might represent a novel therapeutic strategy for depression treatment.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Hipersensibilidade Alimentar/complicações , Imunoglobulina G/imunologia , Adolescente , Biomarcadores/sangue , Proteína C-Reativa , Doença Crônica , Citocinas , Transtorno Depressivo Maior/sangue , Feminino , Hipersensibilidade Alimentar/sangue , Histamina/sangue , Homocisteína/sangue , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Mediadores da Inflamação/sangue , Masculino , Fatores de Risco , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Adulto Jovem
11.
Ideggyogy Sz ; 72(5-6): 201-207, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31241265

RESUMO

Background and purpose: Migraine is a risk factor for ischemic stroke in women of childbearing ages. Previous researches revealed a higher prevalence of hyperhomocysteinemia in migraineurs. Possible differences on the frequencies of hyperhomocysteinemia between migraine with aura and migraine without aura could contribute the established variances in stroke risk between these migraine types. Therefore, we aimed to search if the frequency of hyperhomocysteinemia was different between these subtypes of migraine or not. Methods: We analyzed the findings of serum homocysteine levels in female migraineurs of 16-49 years old who admitted to our outpatient clinic. Results: Homocysteine level was elevated in 13.3% of study population. There were not any significant differences on median serum homocysteine levels between migraine with aura (8.0 mikromol/L) and without aura (8.5 mikromol/L). (p=0.426) The frequencies of hyperhomocysteinemia were also similar (9.1% versus 16.7%, respectively; p=0.373). Correlation analyses did not reveal any linear correlation between ages and homocysteine levels either in group of migraine with aura or in group of migraine without aura (p=0.417 and p=0.647, respectively). Similarly, any linear correlation between disease ages and homocysteine levels either in group of migraine with aura or in group of migraine without aura was not detected (p=0.359 and p=0.849, respectively). Conclusion: The median serum homocysteine levels and the frequencies of hyperhomocysteinemia are similar between migraine with aura and without aura in women of childbearing ages. Therefore, the variances on stroke risk ratios between these types of migraine are probably not originated from the differences of serum homocysteine status.


Assuntos
Homocisteína/sangue , Hiper-Homocisteinemia/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Hiper-Homocisteinemia/sangue , Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/fisiopatologia , Enxaqueca com Aura/epidemiologia , Enxaqueca sem Aura/epidemiologia , Saúde Reprodutiva , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Adulto Jovem
12.
J Stroke Cerebrovasc Dis ; 28(7): 1816-1823, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31080137

RESUMO

OBJECTIVE: To study the inflammatory mechanism of hyperhomocysteinemia on large-artery atherosclerosis based on hypersensitive C-reactive protein in patients. METHODS: In all, 153 inpatients and 1357 physical examinees were selected. The levels of homocysteine were compared between the carotid/intracranial artery stenosis group and the nonstenosis group, between the carotid artery unstable plaque group and the nonplaque group, and between the intima-media thickness (IMT) greater than or equal to 1 group and the normal IMT group. The hypersensitive C-reactive protein levels were compared between the lacunar infarction (LI) group and the nonstroke control group and between the unstable plaque group and the nonplaque group. RESULTS: Homocysteine level was significantly higher in the carotid/intracranial artery stenosis group than in the nonstenosis group, in the LI group than in the inpatient nonstroke group, and in the IMT greater than or equal to 1 group than in the normal IMT group. The hypersensitive C-reactive protein level was significantly higher in the LI group than in the nonstroke group and in the unstable plaque group than in the nonplaque group. CONCLUSIONS: Hyperhomocysteinemia may aggravate the development of IMT, carotid atherosclerotic plaque instability, and carotid/intracranial artery stenosis by increasing inflammation, ultimately leading to the occurrence of LI. Hyperhomocysteinemia-induced inflammation mechanism warrants further study.


Assuntos
Proteína C-Reativa/análise , Estenose das Carótidas/sangue , Homocisteína/sangue , Hiper-Homocisteinemia/sangue , Mediadores da Inflamação/sangue , Inflamação/sangue , Arteriosclerose Intracraniana/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Espessura Intima-Media Carotídea , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/etiologia , Estudos de Casos e Controles , China , Feminino , Humanos , Hiper-Homocisteinemia/complicações , Hiper-Homocisteinemia/diagnóstico , Inflamação/diagnóstico , Inflamação/etiologia , Arteriosclerose Intracraniana/diagnóstico por imagem , Arteriosclerose Intracraniana/etiologia , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica , Prognóstico , Fatores de Risco , Ruptura Espontânea , Índice de Gravidade de Doença
14.
Medicine (Baltimore) ; 98(18): e15499, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045837

RESUMO

Given the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) as a global health threat, understanding the risk factors for MRSA infection in the community may be a reasonable strategy to prevent it. We investigated the associations between serum homocysteine levels and prevalence of nasal colonization with S aureus and MRSA among United States adults. We conducted a cross-sectional analysis of a nationally representative sample of 7832 adults (20 years or older). The main outcome variables were nasal colonization with S aureus and MRSA. Percentages of colonization with S aureus and MRSA were calculated by the quartiles of serum homocysteine. A total of 7832 of 2051 subjects (26.2%) were culture positive for S aureus, 98 (4.8%) of whom had nasal colonization with MRSA. In comparison with subjects having the lowest serum homocysteine, the odds of nasal colonization with MRSA were significantly higher in those with the highest homocysteine (odds ratio, 3.09; 95% confidence interval, 1.11-8.61) in multivariate analysis, adjusted for all confounding variables. By contrast, homocysteine elevation was not significantly associated with S aureus colonization. Nasal colonization with MRSA in the general community was significantly associated with increases in serum homocysteine levels.


Assuntos
Homocisteína/sangue , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Cavidade Nasal/microbiologia , Infecções Estafilocócicas/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Colônia Microbiana , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Prevalência , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Estados Unidos/epidemiologia , Adulto Jovem
15.
Wiad Lek ; 72(4): 532-538, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055527

RESUMO

OBJECTIVE: Introduction: According to present knowledge, hyperhomocysteinemia is one of the risk factors of cardio-vascular pathology. Patients with chronic kidney disease are known to develop hyperhomocysteinemia more often than those in general population. Іmportant cause of hyperhomocysteinemia is the deficiency of vitamins В6, В9 and В12 that are involved in homocysteine metabolism. Vitamins deficiency, we believe, can be one of the causes of hyperhomocysteinemia in the patients with chronic renal failure. The aim: To analyze the plasma homocysteine level in patients with chronic kidney disease and its assosiation with the levels of vitamins B6, B9, B12 in Ukraine. PATIENTS AND METHODS: Materials and methods: The study involved 148 persons with different stagesis of chronic kidney disease who underwent immunoenzyme determination of total plasma homocysteine, B9, cobalamin and vitamin В6 status. RESULTS: Results: It was found that in ukrainian patient population with chronic kidney disease 58.7% of patients have hyperhomocysteinemia. Homocysteine level was shown to increase with the increase of chronic kidney disease stage. Supply of vitamins В6, В9 та В12 in the patients with chronic kidney disease was lower than in apparently healthy persons, but there was significant decrease of folic acid level proportionally to the increase of chronic kidney disease stage. There was close relationship between homocysteine level and folic acid status in the patients with chronic kidney disease, but it appeared to be independent on cobalamin and pyridoxin status. CONCLUSION: Conclusions: The obtained data are promising for finding effective means of correction of hyperhomocysteinemia in patients with chronic kidney disease by normalizing the vitamin status of such patients.


Assuntos
Ácido Fólico/sangue , Homocisteína/sangue , Insuficiência Renal Crônica/sangue , Vitamina B 12/sangue , Vitamina B 6/sangue , Humanos , Ucrânia , Complexo Vitamínico B
16.
Drugs Aging ; 36(5): 419-434, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30949983

RESUMO

BACKGROUND: Vitamin B deficiency and elevated total plasma homocysteine have been associated with cognitive impairment and dementia in later life, although it is unknown if treatment with these vitamins improves cognitive outcomes. OBJECTIVES: The objectives of this study were to examine the efficacy of treatment with vitamin B12, vitamin B6, or folic acid in slowing cognitive decline amongst older adults with and without cognitive impairment. METHODS: We summarized findings from previous systematic reviews of clinical trials and performed a new systematic review and meta-analysis of 31 English-language, randomized placebo-controlled trials of B-vitamin supplementation of individuals with and without existing cognitive impairment. RESULTS: Previous reviews have generally reported no effect of B vitamins on cognitive function in older adults with or without cognitive impairment at study entry, although these vitamins effectively lowered total plasma homocysteine levels in participants. Ten randomized placebo-controlled trials of 1925 participants with pre-existing cognitive impairment and 21 trials of 15,104 participants without cognitive impairment have been completed to date but these generally confirmed findings from previous reviews with the exception of two trials that showed a modest but clinically uncertain benefit for vitamins in people with elevated plasma homocysteine. B-vitamin supplementation did not show an improvement in Mini-Mental State Examination scores for individuals with (mean difference 0.16, 95% confidence interval - 0.18 to 0.51) and without (mean difference 0.04, 95% confidence interval - 0.10 to 0.18) cognitive impairment compared to placebo. CONCLUSIONS: Raised total plasma homocysteine is associated with an increased risk of cognitive impairment and dementia, although available evidence from randomized controlled trials shows no obvious cognitive benefit of lowering homocysteine using B vitamins. Existing trials vary greatly in the type of supplementation, population sampled, study quality, and duration of treatment, thereby making it difficult to draw firm conclusions from existing data. Findings should therefore be viewed in the context of the limitations of the available data and the lack of evidence of effect should not necessarily be interpreted as evidence of no effect.


Assuntos
Transtornos Cognitivos/tratamento farmacológico , Cognição/efeitos dos fármacos , Suplementos Nutricionais , Complexo Vitamínico B/farmacologia , Idoso , Transtornos Cognitivos/sangue , Demência/tratamento farmacológico , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/farmacologia , Homocisteína/sangue , Humanos , Masculino , Vitamina B 12/administração & dosagem , Vitamina B 12/farmacologia , Vitamina B 6/administração & dosagem , Vitamina B 6/farmacologia , Complexo Vitamínico B/administração & dosagem
17.
Int J Mol Sci ; 20(8)2019 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-30999684

RESUMO

Goeckerman therapy (GT) of psoriasis vulgaris is based on the application of crude coal tar and ultraviolet radiation. We investigated DNA damage by the number of micronucleated binucleated cells (MNBC) in lymphocytes, serum homocysteine, vitamin B12, folic acid, and two polymorphisms (C677T and A1298C) in the MTHFR gene in 35 patients with exacerbated psoriasis vulgaris classified according to the psoriasis area and severity index (PASI) score and treated by GT. The median of PASI score decreased from nineteen to five, and MNBC increased from 10 to 18‰ after GT (p < 0.001 in both cases). Correlations of MNBC with homocysteine (Spearman's rho = 0.420, p = 0.012) and vitamin B12 (rho = -0.389, p = 0.021) before the therapy were observed. Hyperhomocysteinemia was an independent predictor of genotoxicity (OR 9.91; 95% CI, 2.09-55.67; p = 0.003). Homocysteine was higher in females than in males (13 vs. 12 µmol/L, p = 0.045). In contrast, vitamin B12 levels in the females were lower than in the males (160 vs. 192 pmol/L, p = 0.047). Vitamin B12 in the females were negatively influenced by smoking status (160 pmol/L in smokers vs. 192 pmol/L in non-smokers, p = 0.025). A significantly higher MNBC was found in CC homozygous patients (A1298C polymorphism) than in AC heterozygotes (32 vs. 16‰, p = 0.005) and AA homozygotes (32 vs. 18‰, p = 0.036). Our data showed that homocysteine participates in the pathogenesis of psoriasis. Its serum levels correlated with MNBC and allowed the prediction of DNA damage to appear within GT. Both micronutrients status and homocysteine metabolic pathway contribute to the genotoxicity of GT.


Assuntos
Alcatrão/uso terapêutico , Ceratolíticos/uso terapêutico , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Polimorfismo de Nucleotídeo Único , Psoríase/genética , Psoríase/terapia , Terapia Ultravioleta/métodos , Adulto , Dano ao DNA/efeitos dos fármacos , Dano ao DNA/efeitos da radiação , Ácido Fólico/sangue , Homocisteína/sangue , Humanos , Testes para Micronúcleos , Micronutrientes/sangue , Pessoa de Meia-Idade , Psoríase/sangue , Psoríase/patologia , Vitamina B 12/sangue
19.
Saudi Med J ; 40(4): 347-352, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30957127

RESUMO

OBJECTIVES: To assess the differences in the parameters that are metabolically related to cardiovascular diseases after weight loss in obese people with coronary artery diseases (CADs). METHODS: This study was conducted on 184 patients who were diagnosed with CADs in Istanbul University Cardiology Institute Hospital, Istanbul, Turkey. The levels of leptin, fibrinogen, homocysteine, high-sensitivity C-reactive protein (hs-CRP), triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), fasting blood glucose and insulin, glycated hemoglobin, and uric acid of the obese patients who were put on calorie restricted diet were evaluated retrospectively and compared before and after weight loss. For comparison, non-obese control patients were also studied. Student's t-test and Chi-square test were used for the statistical analysis. Results: Levels of homocysteine, glycated hemoglobin, and leptin were significantly higher in the obese patients than in the non-obese patients. Diabetic obese patients with CADs lost (11.1%) and non-diabetic obese patients with CADs lost (10.5%) of their body weight in 6 months. The levels of cholesterol, LDL-C, and fibrinogen were significantly improved in both groups. Conclusion: The obese patients lost weight after being on calorie-restricted diets and showed significant improvement in the levels of cholesterol, LDL-C, fibrinogen. There was no significant difference in the levels of homocysteine, hs-CRP, and leptin before and after weight loss in both diabetic and non-diabetic obese patients.


Assuntos
Doenças Cardiovasculares/metabolismo , LDL-Colesterol/sangue , Colesterol/sangue , Fibrinogênio/metabolismo , Obesidade/metabolismo , Perda de Peso/fisiologia , Adulto , Idoso , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , Distribuição de Qui-Quadrado , HDL-Colesterol/sangue , Dieta Redutora , Feminino , Hemoglobina A Glicada/metabolismo , Homocisteína/sangue , Humanos , Insulina/sangue , Leptina/sangue , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue , Ácido Úrico/sangue
20.
Orphanet J Rare Dis ; 14(1): 66, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30871635

RESUMO

BACKGROUND: The Registry of Adult and Paediatric Patients Treated with Cystadane® - Homocystinuria (RoCH) is a non-interventional, observational, multi-centre, post-authorization safety study that aimed to identify safety of betaine anhydrous (Cystadane®) in the treatment of patients with inborn errors of homocysteine metabolism (homocystinuria) in order to minimise the treatment associated risks and establish better knowledge on its clinical use. The registry included patients of all ages with homocystinuria who were treated with betaine anhydrous in conjunction with other therapies. Clinical data were collected retrospectively from 2007 to 2013, then prospectively up to February 2014. All adverse events (AEs) reported during the study were recorded. The clinical and biological status of patients was monitored at least once a year. RESULTS: A total of 125 patients with homocystinuria (adults [> 18 years]: 50; paediatric [≤18 years]: 75) were enrolled at 29 centres in France and Spain. Patients were treated with betaine anhydrous for a mean duration of 7.4 ± 4.3 years. The median total daily dose of betaine anhydrous at the first and last study visits was 6 g/day for cystathionine ß-synthase (CBS)-deficient vitamin B6 responders and 9 g/day for methylenetetrahydrofolate reductase-deficient patients, while the median daily dose increased in CBS-deficient B6 non-responders (from 6 to 9 g/day) and cobalamin metabolism-defective patients (from 3 to 6 g/day) between the first and last visits. Treatment caused a mean overall reduction of 29% in plasma homocysteine levels in the study population. A total of 277 AEs were reported during the study, of which two non-serious AEs (bad taste and headache) and one serious AE (interstitial lung disease) were considered to be drug related. Overall, betaine anhydrous was well tolerated with no major safety concerns. CONCLUSIONS: Data from the RoCH registry provided real-world evidence on the clinical safety and efficacy of betaine anhydrous in the management of homocystinuria in paediatric and adult patients.


Assuntos
Betaína/administração & dosagem , Homocistinúria/tratamento farmacológico , Sistema de Registros , Adolescente , Adulto , Betaína/efeitos adversos , Criança , Pré-Escolar , Feminino , França , Homocisteína/sangue , Humanos , Lactente , Masculino , Estudos Retrospectivos , Espanha , Resultado do Tratamento , Adulto Jovem
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