ObjectivesTo evaluate the association between high homocysteine (Hcy) levels and risk of contrast-induced nephropathy (CIN).MethodsCNKI, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect the case-control studies on the association between Hcy and risk of CIN from inception to November 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software.ResultsTen case-control studies involving 6 124 subjects were included. Meta-analysis showed that the high Hcy level was associated with an increased risk of CIN (OR=1.59, 95%CI 1.33 to 1.89, P<0.001), and the homocysteine level in CIN group was higher than that in non-CIN group (WMD=8.74, 95%CI 6.18 to 11.31,P<0.001).ConclusionsAccording to the current evidence, the high Hcy level is a risk factor for CIN. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
Homocysteine is an intermediate product of methionine and cysteine metabolism, and plays a key role in methylation. Epilepsy is one of the common diseases of the nervous system, long-term repeated seizures will not only cause damage to the brain tissue, but also cause cognitive impairment. At present, the clinical treatment for epilepsy is still mainly to control symptoms, the fundamental etiology of epilepsy still needs to be improved, to explore the etiology of seizures, fundamentally control seizures, is still our long-term struggle direction. High homocysteine is associated with many diseases. Epidemiological studies have shown that the serum homocysteine level of 10% ~ 40% of epilepsy patients is higher than that of the normal population. By exploring the relationship between serum Hcy and epilepsy,We expect to provide help for the diagnosis and treatment of clinical epilepsy.
Diabetic retinopathy is a vascular complication of diabetes, and homocysteine is an intermediate product of methionine metabolism. Hyperhomocysteinemia can directly or indirectly damage vascular endothelial cells, causing vascular endothelial cells dysfunction and participating in the occurrence and development of diabetic retinopathy. Uric acid is the final product of purine metabolism. Hyperuricemia can cause vascular endothelial dysfunction, oxidative metabolism, platelet adhesion and aggregation dysfunction, thus participating in the occurrence and development of diabetic retinopathy. In recent years, there have been many studies on the correlation between diabetic retinopathy and levels of homocysteine and uric acid. This article reviews the relevant literature at home and abroad in order to provide new information for the prevention and treatment of diabetic retinopathy.
ObjectiveTo study the correlation between neck artery vascular sclerosis and homocysteine levels in hypertensive patients. MethodsA total of 2 132 patients with hypertension participated in the program of "Stroke screening and prevention in Dongying city" were included from Sep. 2012 to Jan. 2013. Questionnaire, physical examination, biochemical blood tests and carotid artery ultrasound were conducted in all included patients. According to the level of homocysteine (Hcy), patients were divided into three groups:716 patients with Hcy level less than 12.3 mm/L were in Group 1, 703 patients with Hcy level 12.3 to 16.5 mm/L were in Group 2, and 713 patients with Hcy level more than 16.5 mm/L were in Group 3. The influence of Hcy levels on carotid atherosclerosis was analyzed. Results① The prevalence rate for carotid plaques in Groups 1, 2, and 3 were 50.28%, 60.03% and 65.36%, respectively. The prevalence rate for carotid plaques in Group 2 was higher than that in Group 1 with a statistical difference (OR=1.485, 95% CI 1.203 to 1.833, P=0.000). The prevalence rate in Group 3 was also higher than that in Group 1 with a statistical difference (OR=1.866, 95% CI 1.508 to 2.308, P=0.000). ② The prevalence rate for carotid plaques was 62.24% in the rural population, and 52.39% in the urban population. The difference between urban and rural populations was statistically significant (OR=1.500, 95% CI 1.259 to 1.788, P=0.000). ③ Using the presence of carotid plaques as a dependent variable and Hcy level as a covariant, logistic regression analysis found that the plaque formation in Group 2 was 1.491 times than in Group 1 and the plaque formation in Group 3 was 1.752 times than in Group 1. After adjusting the risk factors (gender, age, BMI, TG, TC, LDL-C, HDL-C and blood sugar level), the results showed that the plaque formation in Group 2 was 1.388 times than in Group 1, and the plaque formation in Group 3 was 1.452 times than in Group 1. ConclusionThere is a correlation between the increased incidence of carotid plaque and homocysteine levels in patients with hypertension. The incidence of carotid plaque in the rural population with hypertension is higher than that in the urban population. In the population with hypertension, high homocysteine level is an independent risk factor for the formation of carotid plaques.
目的 研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。 方法 2010年2月－4月间筛选AECOPD患者16例和健康志愿者（对照组）13例，测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢（H2S）、丙二醛（MDA）、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率（半胱氨酸浓度/胱硫醚浓度）与胱硫醚转化率（胱硫醚浓度/同型半胱氨酸浓度）参与分析。 结果 ① 加重期血清MDA水平[（7.3 ± 5.1）nmol/L ]比缓解期[（3.0 ± 1.4）nmol/L ]和对照组[（3.0 ± 2.2）nmol/L ]均升高（P＜0.01）；血清MDA水平与第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1%预计值）呈负相关。② 加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低（P＜0.01）；缓解期血清H2S水平[（47.2 ±5.1） μmol/L ]高于对照组[（38.8 ± 2.1） μmol/L ]，P＜0.01；血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关（r=0.651、0.680，P＜0.01），均与血清MDA水平呈负相关（r=-0.334、-0.448，P＜0.05）。③ 加重期半胱氨酸转化率（3.97 ± 2.41）低于缓解期（5.92 ± 2.18）与对照组（6.14 ± 3.15）差异有统计学意义（P＜0.05）；而胱硫醚转化率则相反。④ 叶酸与维生素B12水平各组间均无差异。 结论 提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归，减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。Objective To study the roles of homocysteine (Hcy) transsulfuration pathway, Vitamin B6 and endogenous hydrogen sulfide in treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixteen AECOPD patients and 13 healthy controls (Control group) from February to April 2010 were recruited in this study. Lung function, serum hydrogen sulfide (H2S), malondialdehyde (MDA), folate, vitamin B12, C-reactive protein (CRP), interleukin-6 (IL-6), Hcy, cystathionine, cystein (Cys) and vitamin B6 were all measured for all the patients in the acute exacerbation period and alleviation period and healthy controls. The conversion rate of Cys (expressed as Cys/cystathionine) and the conversion rate of cystathionine (expressed as cystathionine/Hcy) were calculated for analysis. Results Serum MDA level for patients in the acute exacerbation period (AE period) [(7.3 ± 5.1) nmol/L] was significantly higher than that in the alleviation period [(3.0 ± 1.4) nmol/L] and in the healthy controls [(3.0 ± 2.2) nmol/L] (P ＜ 0.01). Serum MDA level was negatively correlated with percentage of FEV1 in predicted FEV1 (FEV1% pred) and FEV1/FVC. Serum H2S level and plasma vitamin B6 level for patients in the AE period were significantly lower than those in the alleviation period and in the healthy controls (P ＜ 0.01), and serum H2S level was significantly higher in the alleviation period [(47.2 ± 5.1) μmol/L] than in the controls [(38.8 ± 2.1) μmol/L] (P ＜ 0.01). Both serum H2S and plasma vitamin B6 levels were correlated positively with FEV1% pred for patients in the AE period and healthy controls (r=0.651, 0.680; P ＜ 0.01), but negatively correlated with serum MDA level (r=-0.334, -0.448; P ＜ 0.05). The conversion rate of Cys for patients in the AE period (3.97 ± 2.41) was significantly lower than that in the alleviation period (5.92 ± 2.18) and the control group (6.14 ± 3.15) (P ＜ 0.05), but the conversion rate of cystathionine was just the opposite (P ＜ 0.05). There were no significant differences in the levels of serum folate and vitamin B12 among the three groups. Conclusion Raising the Vitamin B6 and H2S level may facilitate stabilizing of conditions in patients with AECOPD and reduce oxidative stress. Therefore, it may become a new treatment method for AECOPD.
Objective To explore the relevance of serum homocysteine (Hcy) level to erythrocyte and platelet parameters in patients with unstable angina pectoris (UAP). Methods Sixty patients with UAP were collected in Tongling Municipal Hospital from August 1st, 2012 to December 31st, 2015. Serum Hcy was measured by enzymatic cycling method. Erythrocyte parameters, such as red blood cell count (RBC), hemoglobin, mean corpuscular volume (MCV), coefficient of variation of red blood cell volume distribution width (RDW-CV), and platelet parameters, such as platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (P-LCR), were measured with blood cell counter. All patients were classified into UAP with hyperhomocystinemia (HHcy) group and UAP with normal Hcy group according to the level of Hcy. The data in two groups were analyzed and the relevance of serum Hcy level to erythrocyte and platelet parameters was evaluated. Results The differences in the levels of RBC, hemoglobin, MCV, PLT, PDW, MPV, P-LCR between the two groups were not statistically significant (P>0.05); while the levels of RDW-CV and the proportion of RDW-CV above the upper reference limit of patients in the UAP with HHcy group (13.81%±1.13%, 39.4%) were higher than those in the UAP with normal Hcy group (13.06%±0.97%, 4.8%), and the differences between the two groups were statistically significant (P<0.05). Correlation analysis showed that serum Hcy level of patients with UAP was significantly correlated with RDW-CV (r=0.380, P<0.01) and was not significantly correlated with other erythrocyte and platelet parameters (P>0.05). Conclusion The high level of Hcy affects red blood cell volume heterogeneity in patients with UAP, which may be one of the mechanisms of HHcy participating in the occurrence and development of UAP.
摘要:目的: 探讨动脉硬化闭塞症(ASO)和静脉血栓形成(VT)患者同型半胱氨酸(Hcy)变化。 方法 :通过循环酶法对34例非动脉硬化闭塞症(ASO)和静脉血栓形成(VT)患者(对照组),30例动脉硬化闭塞症(ASO)患者和26例静脉血栓形成(VT)患者血液中Hcy进行测定。 结果 :循环酶法测定HCY的批内平均变异系数为2．23％,批间平均变异系数为1．59％。34例对照组,〖WTBX〗t =1135,〖WTBX〗P =0266gt;005;动脉硬化闭塞症(ASO)组Hcy含量明显高于对照组(〖WTBX〗P lt;O．05),静脉血栓形成(VT)组Hcy含量高于对照组(〖WTBX〗P lt;0．O5)。 结论 :高同型半胱氨酸血症可能是动脉硬化闭塞症(ASO)和静脉血栓形成(VT)及复发的致病因素。可将同型半胱氨酸作为动脉硬化闭塞症(ASO)和静脉血栓形成(VT)及复发的重要指标。Abstract: Objective: TO syudy the changes of the Homocysteine about Atherosclerosis obliterans and Venous thrombosis patients. Methods : To measure the Hcy in the blood of 34 healthy cases both non ASO and non VT(the comparison group),30 cases of ASO patients and 26 cases of VT patients respectively by enzymatic cycling assay。〖WTHZ〗Results :The average variation coefficient of Hcy within the groups was 223% and among the groups was 159% measured by enzymatic cycling assay.In the 34 cases of comparison group,t=1135,P=0266gt;005,The content of Hcy in the blood of ASO patients group were significantly higher than the comparision group (Plt;005),and the content of Hcy in the blood of VT patients group were also higher than the comparison group (Plt;005). Conclusion : Hyper Hcy may be the pathogenic diathesis to form or to recrudesce ASO and VT.So we can treat Hcy as the significant index to form or to recrudesce ASO and VT.
Objective To observe the relationship of serum levels of homocysteine (HCY) and chemokine C-C motifligand 2 (CCL2) with cognitive impairment in COPD patients with different degrees of emphysema. Methods Sixty-twoCOPD patients identified according to emphysema phenotype classification and admitted from January 2016 to March 2017 were recruited in the study. There were 37 cases in emphysema 1-2 grade and 25 cases in emphysema 3-4 grade. Simultaneous 30 healthy subjects undergoing physical examination were recruited as control. Montreal cognitive assessment (MoCA) scale investigation and serum HCY and CCL2 test were completed. Relationship analysis was conducted on serum HCY, CCL2 levels with cognitive impairment in the COPD patients with different degrees of emphysema. Results Compared with the 1-2 grade subgroup, the PaO2 was lower, PaCO2 was higher, the plasma HCY and CCL2 levels increased in the 3-4 grade subgroup with significant differences (all P<0.05). MoCA total score and subscores were relatively low in the COPD group with emphysema than the control group (except visuospatial ability scores in the 1-2 grade subgroup). MoCA scores were statistically lower in the 3-4 grade subgroup than those in the 1-2 grade subgroup (allP<0.05). Correlation analysis showed that HCY and CLL2 levels were negatively correlated with MoCA scores and subscores (P<0.01), and HCY and CLL2 were positively correlated (bothP<0.01). The area under the receiver operating characteristic curve of HCY and CLL2 for evaluating cognitive impairment was 0.79 and 0.97, respectively. Conclusion In patients with different degrees of emphysema phenotype, serum HCY and CCL2 levels are increased in different degree, and the degree of emphysema is closely related with cognitive dysfunction.
Objective To observe the correlation between homocysteine (Hcy) and serum uric acid (SUA) and retinopathy in type 2 diabetes mellitus (T2DM), preliminary study on its predictive value. MethodsA retrospective study. From January 2020 to March 2021, a total of 324 T2DM patients hospitalized in Department of Endocrinology, Cangzhou Central Hospital of Hebei Province were included. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), serum creatinine (Scr), blood urea nitrogen (BUN), Hcy, SUA, peripheral blood endothelial progenitor cells (EPC), circulating endothelial cells (CEC) were counted and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. According to the absence or presence of diabetic retinopathy (DR), the patients were divided into non DR (NDR) group and DR group with 100 and 214 cases, respectively. Clinical data and laboratory biochemical indexes of the two groups were compared and observed. The logistic regression was used to analyze the independent risk factors for DR in T2DM patients. Smooth curve fitting was used to analyze the curve relationship between Hcy, SUA and DR, and ROC area (AUC) of Hcy, SUA; their combined prediction of DR in T2DM patients was calculated by receiver operating characteristic curve (ROC curve), and the predictive value of Hcy and SUA for DR in T2DM patients was evaluated. ResultsDiabetic course (t=5.380), systolic blood pressure (t=2.935), hypertension (χ2=10.248), diabetic nephropathy (χ2=9.515), diabetic peripheral neuropathy (χ2=24.501), FBG (t=3.945), HbA1C (t=3.336) and TG in DR Group (t=2.898), LDL-C (t=3.986), Scr (t=2.139), SUA (t=7.138), HOMA-IR (t=3.237), BUN (t=3.609), Hcy (t=2.363) and CEC (t=19.396) were significantly higher than those in NDR group. The difference was statistically significant (P＜0.05). EPC (t=9.563) and CPC (t=7.684) levels were significantly lower than those of NDR group, and the difference was statistically significant (P＜0.05). Logistic regression analysis showed that diabetes course, SBP, hypertension, FBG, HbA1C, LDL-C, SUA, Hcy, EPC, CPC and CEC were all independent risk factors for developing DR in T2DM patients (P＜0.05). The smooth curve fitting analysis showed that Hcy and SUA were positively correlated with the occurrence of DR. After adjusting for confounding factors, when Hcy≥15 μmol/L, the risk of DR Increased by 14% for every 1 μmol/L increase in Hcy [odds ratio (OR)=0.92, 95% confidence interval (CI) 0.88-0.98, P＜0.05]. When Hcy＜15 μmol/L, there was no significant difference (OR=0.96, 95%CI 0.92-1.08, P＞0.05). When SUA≥304 μmol/L, the risk of DR increased by 17%, every 20 μmol/L SUA increased (OR=0.80, 95%CI 0.68-0.94, P＜0.05). When SUA＜304 μmol/L, the difference was not statistically significant (OR=0.83, 95%CI 0.72-0.95, P＞0.05). ROC curve analysis results showed that the AUC values of Hcy, SUA and Hcy combined with SUA in predicting the occurrence of DR in T2DM patients were 0.775 (95%CI 0.713-0.837, P＜0.001), 0.757 (95%CI 0.680-0.834, P＜0.001) and 0.827 (95%CI 0.786-0.868, P＜0.001). Hcy combined with SUA showed better predictive efficiency. ConclusionsThe abnormal increase of Hcy and SUA levels in T2DM patients are closely related to the occurrence of DR, they are independent risk factors for the occurrence of DR. Hcy combined with SUA has high predictive value for the occurrence of DR.