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.
【Abstract】ObjectiveTo detect the levels of homocysteine (Hcy) and anti-phospholipid antibodies (APLA) in the hematoplasma of the patients with deep venous thrombosis (DVT), discuss the reason of DVT recurrence and search for the predictors of it. MethodsSixty cases with DVT in our department from January 2001 to April 2003 were collected, which were divided equally into two groups as primary and recurrent, and first degree relative of the 30 DVT recurrent patients were also collected. The author established a control group using 30 cases of outpatient clinic without varicose veins of lower extremity or insufficient venae profundae. Hcy was detected with fluorescence polarization immunoassay (FPIA) and APLA 〔anticardiolipin antibody, ACLA (IgG, IgM); lupus antibody (LA)〕were detected with enzyme linked immunosorbent assay (ELISA). Odds ratios (OR) were also calculated to assess the relative risk of each study group. ResultsThe values of Hcy and ACLA （IgG， IgM） in the primary group and recurrent group were both significantly higher than those of control group and first degree relative group of DVT recurrent patients (Plt;0.01). The values of Hcy in first degree relative group of DVT recurrent patients was were also much higher than that of control group (Plt;0.05). The 90% quantity of Hcy in control group was 13.1 μmol/L and if taking it as the normal value, the number of cases exceeded this value in primary group, recurrent group and first degree relative group of DVT recurrent patients were 14, 21 and 13 and the OR of them were 2.31, 2.20 and 1.90, respectively. The positive rates of LA were not statistically significant in each group. Conclusion The values of Hcy and APLA both rise in the hematoplasma of DVT patients. There are close relationship between the levels of Hcy and APLA and DVT. The recurrence of DVT is related to high level of Hcy and Hcy is possibly a predictor of DVT.
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.
Objective To observe the serum homocysteine (Hcy) levels in retinal branch vein occlusion (BRVO) patients with with hypertension or non-hypertension. Methods A total of 120 patients (120 eyes) with BRVO were divided into hypertension group [72 eyes, blood pressure 140 - 175/90 - 105 mmHg (1 mmHg=0.133 kPa)] and non-hypertension group (48 eyes, blood pressure 100 - 139/70 - 88 mmHg). According to the sex and age, 78 patients with hypertensive non-retinal vascular diseases and 48 patients with non-hypertensive and non-retinal vascular diseases were collected by a way of same-size ratio as hypertension control group and non-hypertension control group, respectively. Fasting venous blood was collected from all patients in the morning and serum Hcy levels were measured by rate method. The total Hcy concentration over 15.0 μ mol/L was defined as high level Hcy. Fasting serum glucose and fasting serum lipid were also measured. Measurement data among groups were compared with t test. Results The serum Hcy levels were (26.82±28.0), (8.39±3.11), (21.37±4.24), (9.25±3.31) μmol/L in the hypertension group, hypertension control group, non-hypertension group and non-hypertension control group, respectively. The serum Hcy levels of patients in the hypertension group was significantly higher than that in the hypertension control group (t=3.324, P=0.004). The serum Hcy levels of patients in the non-hypertension group was significantly higher than that in the non-hypertension control group (t=2.216, P=0.049). The serum Hcy levels of patients in the hypertension group was significantly higher than that in the non-hypertension group, but the difference had not statistical significance (t=0.581, P=0.566). Among 120 patients, there were 68 patients (56.67%) with high level of Hcy (40 patients in the hypertension group and 28 patients in the non-hypertension group). Among the 40 patients with high levels of Hcy in the hypertension group, 36 patients were older than 50 years old (90.00%) and 4 patients were less or equal than 50 years old (10.00%). Among the 28 patients with high levels of Hcy in the non-hypertension group, 16 patients were older than 50 years old (57.14%); 12 patients were less or equal than 50 years old (42.86%), whose indexes of serum glucose and serum lipid were not abnormal. There was significant difference in age distribution of patients with high level of Hcy between the hypertension group and the non-hypertension group (χ2=9.882, P=0.002), but there was no significant difference in sex distribution (χ2=2.052, P=0.216). Conclusions The level of serum Hcy increased both in BRVO patients with hypertension and non-hypertension. The indexes of serum glucose and serum lipid were not abnormal in BRVO patients aged less or equal than 50 years old with non-hypertensive except for the increase of serum Hcy level.
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.
Objective To assess the effect of B vitamins supplementation on cardiovascular and cerebrovascular diseases, and also to evaluate the relationship between homocysteine and risk of cardiovascular and cerebrovascular diseases. Methods Using the words ‘homocysteine’, ‘cardiovascular disease’, ‘cerebrovascular disease’, ‘B vitamins’, and ‘randomized controlled trial’, we searched PubMed, Ovid, and Springer. We also hand searched relevant journals and conference proceedings. Randomized controlled trials published between 1998 and July 2008 which evaluated the effect of B vitamins supplementation on vascular diseases were collected. Two reviewers independently screened trials, extracted data, and evaluated the quality of included trials. The Cochrane Collaboration’s RevMan 4.2 software was used for statistical analysis. Results Sixteen trials involving 27,043 patients with vascular disease were included. Results of meta-analyses showed that no significant differences were identified between the B vitamins group and the control group for each of the four endpoints, including the risk of cardiovascular events (RR 0.98, 95%CI 0.94 to 1.03), the risk of coronary heart disease (RR 0.99, 95%CI 0.92 to 1.07), the risk of stroke (RR 0.90, 95%CI 0.80 to 1.02), and the total mortality (RR 0.98, 95%CI 0.92 to 1.05). Sensitivity analyses conducted by a random effect model or with the exclusion of low-quality trials did not change the overall results. Conclusion The trials currently available cannot confirm the causal relationship between homocysteine and risk of cardiovascular and cerebrovascular diseases. More evidence from large-scale randomized controlled trials is needed to confirm this. There is not sufficient evidence to show that B vitamins supplementation can lower the risk of cardiovascular and cerebrovascular diseases. B vitamins supplementation should not be recommended for the secondary prevention of such diseases.
Objective To explore the correlation between homocysteine （Hcy） level and the risk of breast cancer，and try to find a new method to reduce the risk factors and benefit for treatment of breast cancer. Methods From January2010 to December 2012， 245 cases of breast cancer （breast cancer group）， 109 cases of benign breast tumor （benign breast tumor group）， and 78 cases of healthy women （healthy control group） in the Sichuan Provincial People’s Hospital， who were in accordance with the inclusion criteria， were analyzed retrospectively. The difference of Hcy level was compared among three groups. Meanwhile the relation between Hcy level and patients’s age， blood glucose， serum creatinine， estrogen receptor （ER）， progesterone receptor （PR）， Ki-67 （%）， tumor diameter， or axillary lymph node status was analyzed.Results ① The Hcy level was significantly different among the breast cancer group， benign breast tumor group， and healthy control group （P＜0.001）. The Hcy level of the breast cancer group was significantly higher than those of the benignbreast tumor group （P＜0.001） or healthy control group （P＜0.001）， but the Hcy level was not significantly different bet-ween the benign breast tumor group and healthy control group （P=0.082） . ② The Hcy levels of different types of the breastcancer （type of Luminal A， Luminal B， Her-2， and triple negative） were significantly higher than those of the benign breast tumor group （except for Her-2 type， P＜0.05） or healthy control group （P＜0.05）. ③Plasma Hcy level of the patients with benign and malignant breast tumor was positively correlated with age （r=0.197， P=0.004） or serum creatinine level （r=0.381， P＜0.001）， but not correlated with blood glucose （r=0.023， P=0.668）. ④Plasma Hcy level of the patients with malignant breast tumor was positively correlated with age （r=0.267， P=0.007） or serum creatinine level （r=0.341， P＜0.001）， but not correlated with blood glucose （r=-0.005， P=0.935）， tumor diameter （r=-0.049， P=0.443）， axillary lymph node status （r=-0.006， P=0.921）， or Ki-67 （%） （rs=-0.029， P=0.650）. Conclusions Plasma Hcy level of breast cancer patient is abnormally elevated， and it may have some relation with the occurrence of breast cancer.
ObjectiveTo investigate the relationship between the level of homocysteine (HCY) and the overall burden of cerebral small vessel disease (CSVD) in patients with ischemic stroke.MethodsA total of 322 patients with first-ever ischemic stroke admitted to the People’s Hospital of Deyang City between January 2016 and December 2017 were enrolled. The patients’ demographic information, clinical information, and serum HCY concentration were collected after admission. The presence or absence of a CSVD was assessed by MRI and the overall burden score for the CSVD was determined. Multivariate logistic regression analysis was used to assess whether serum HCY level was associated with the overall burden of CSVD.ResultsThe median level of HCY was 13.2 μmol/L (inter-quartile range: 4.3 to 22.6 μmol/L). Univariate analysis showed that the difference of HCY levels among patients with different total CSVD scores was statistically significant (F=6.874, P=0.001); Spearman correlation analyses showed that the HCY level grouped by quartiles was correlated to the number of lacunar infarctions (rs=0.267, P=0.001), Fazekas score of white matter lesions (rs=0.122, P=0.042), and enlarged perivascular space (EPV) score (rs=0.319, P=0.001), but was not correlated to cerebral microhemorrhage (rs=−0.010, P=0.869). After multivariate regression analysis to adjust the effects of other factors, compared with the patients with HCY levels in the lowest quartile group, the patients with HCY levels in the highest quartile group were more likely to develop lacunar infarction [odds ratio (OR)=1.892, 95% confidence interval (CI) (1.012, 2.987)], white matter lesions [OR=1.548, 95%CI (1.018, 1.654)], severe EPV [OR=6.347, 95%CI (3.592, 13.978)], and the increase in the CSVD score [OR=2.981, 95%CI (1.974, 5.398)].ConclusionIn patients with ischemic stroke, elevated HCY levels may be associated with the overall burden of the CSVD.
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.
ObjectiveTo observe the alteration of serum homocysteine (Hcy) levels of advanced non-small cell lung cancer (NSCLC) patients during gemcitabine with cis-platinum (GP) program of chemotherapy and to explore the clinical value of monitoring Hcy in evaluating chemotherapy curative effect. MethodsA total of 49 advanced NSCLC patients (including 28 squamous carcinoma and 21 adenocarcinoma) first treated between May 2012 and April 2015 were selected. The Hcy, cytokerantin-19-fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) levels of the morning fasting venous blood were measured before the first and after the second cycle of chemotherapy. Combined the pathological types of NSCLC, statistical analysis was carried out on the test results. ResultsAll of the 49 patients completed two cycles of GP chemotherapy, and the chemotherapy was effective on 31 and ineffective in 18. Before the chemotherapy, the differences in the positive rates of Hcy, CYFRA21-1, and CEA were statistically significant respectively between squamous carcinoma and adenocarcinoma patients (P < 0.05). But when combined the two types, the differences of three indicators's positive rates were not significant (P > 0.05). After two cycles of GP chemotherapy, in the patients with effective chemotherapy, the Hcy, CYFRA21-1 and CEA levels were lower in both squamous carcinoma and adenocarcinoma patients compared with that before the chemotherapy; the difference in the decrease of Hcy levels in both of the two pathological types was significant (P < 0.05), while CEA levels was significant only in adenocarcinoma patients (P < 0.05) and CYFRA21-1 levels was significant only in squamous carcinoma patients (P < 0.05). Among the patients with ineffective chemotherapy, the Hcy, CYFRA21-1 and CEA levels increased compared with those before the chemotherapy; the difference in the increase of Hcy levels were significant in both of the two pathological types (P < 0.05), while CYFRA21-1 levels was significant only in squamous carcinoma patients (P < 0.05) and CEA levels was not significant in both of the two pathological types (P > 0.05). ConclusionThe effect of chemotherapy and the pathogenetic condition can be assessed by monitoring serum Hcy levels of NSCLC patients during the chemotherapy.