Is Hyperhomocysteinemia a Risk Factor for Ischemic Stroke?A Case Control Study
,
Abstract
Objective: The results of the previous studies on the correlation between plasma levels of Homocysteine (Hcy) and ischemic stroke have been controversial. The aim of the present study is to investigate this correlation meticulously observing risk factors for the ischemic stroke as well as factors affecting the plasma levels of Hcy.Method: A case-control study was conducted between 2005-2006 with cases (55-84 years of age) who had never had a Transient Ischemic Attack (TIA) all within one week of their first-ever ischemic stroke. The 30 control subjects who had never had a stroke or TIA episode were selected from the orthopedics ward of the same hospital. The cases and controls were paired based on age, sex, cardiac disease, hypertension and smoking status and were adjusted for other risk factors. Their total non-fasting plasma Hcy level was determined using the High-Performance Liquid Chromatography (HPLC) method.
Results: The mean plasma levels of Hcy was significantly higher in cases than controls (mean= 20.79 11.938 versus 14.45 8.028 mol/L; P<0.017). After using the multivariate logistic regression model, a significant correlation was found between plasma levels of Hcy and stroke (OR=1.149 with 95% of 1.032-1.280 for each 1 mol/L increment).
Conclusion: The results indicate that there is a correlation betweenincreasing plasma Hcy level and ischemic stroke ; however, future research is needed to prove the causal relationship between the two.
Sacco RL. Pathogenesis, classification, and epidemiology of cerebrovascular disease. In: Rowland L, eds. Merritt’s Neurology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 217-229.
Bautista LE, Arenas IA, Peٌuela A, Marti´nez LX. Total plasma homocysteine level and risk of cardiovascular disease A meta-analysis of prospective cohort studies. J Clin Epidemiol 2002; 55: 882-887.
Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995; 274: 1049-1057.
Conri C, Constans J, Parrot F, Skopinski S, Cipriano C. Homocysteinemia: role in vascular disease. Presse Med 2000; 29: 737-741.
Coull BM, Malinow MR, Beamer N, Sexton G, Nordt F, de Garmo P. Elevated plasma homocyst (e) ine concentration as a possible independent risk factor for stroke. Stroke 1990; 21: 572-576.
Fallon UB, Elwood P, Ben-Shlomo Y, Ubbink JB, Greenwood R, Smith GD. Homocysteine and ischaemic stroke in men: the Caerphilly study. BMJ 2001; 55: 91-96.
Giles WH, Croft JB, Greenlund KJ, Ford ES, Kittner SJ. Total Homocyst (e) ine Concentration and the Likelihood of Nonfatal Stroke Results From the Third National Health and Nutrition Examination Survey, 1988-1994. Stroke 1998; 29: 2473-2477.
Howard V, Sides EG, Newman GC, Cohen SN, Howard G, Malinow MR, Toole JF. Changes in plasma homocysteine in the acute phase after stroke. Stroke 2002; 33: 473-478.
Matsui T, Arai H, Yuzuriha T, Yao H, Miura M, Hashimoto S, et al. Elevated Plasma Homocysteine Levels and Risk of Silent Brain Infarction in Elderly People. Stroke 2001; 32: 116-1119.
Meiklejohn DJ, Vickers MA, Dijkhuisen R, Greaves M. Plasma Homocysteine Concentrations in the Acute and Convalescent Periods of Atherothrombotic Stroke. Stroke 2001; 32: 57-62.
Mّller J, Nielsen GM, Tvedegaard KC, Andersen NT, Jّrgensen PE. A meta-analysis of cerebrovascular disease and hyperhomocysteinaemia. Scand J Clin Lab Invest 2000; 60: 491-500. 1. 12. Verhoef P, Hennekens CH, Malinow MR, Kok FJ, Willett WC, Stampfer MJ. A prospective study of plasma homocysteine and risk of ischemic stroke. Stroke 1994; 25: 1924- 1930.
Hankey GJ. Is plasma homocysteine a modifiable risk factor for stroke? Nat Clin Pract Neurol 2006; 2: 26-33.
Pezzini A, Del Zotto E, Padovani A, Bahceciler NN, Ozdemir C, Barlan IB, et al. Homocysteine and Cerebral Ischemia: Pathogenic and Therapeutical Implications. Curr Med Chem 2007; 14: 249.
Ford E, Smith SJ, Stroup DF, Steinberg KK, Mueller PW, Thacker SB. Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case- control studies and nested case-control studies. Int J Epidemiol 2002; 31: 59-70.
Lindgren A, Brattstrom LE, Norrving B, B. Hultberg, A. Anderson and B.B. Johansson. Plasma homocysteine in the acute and convalescent phase after stroke. Stroke 1995; 26: 795–800.
| Files | ||
| Issue | Vol 3 No 2 (2008) | |
| Section | Articles | |
| Keywords | ||
| Brain ischemia Cerebrovascular disorders Homocysteine Risk factors | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
