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Hyperhomocysteinemia and thrombosis
1Division of Molecular and Genetic Medicine, Royal Hallamshire Hospital, Sheffield, UK.
Insights
Patients with homocystinuria face higher risks of blood clots. While vitamins can lower homocysteine levels, their impact on the disease
Area of Science:
- Cardiovascular Science
- Metabolic Disorders
- Hematology
Background:
- Homocystinuria is linked to elevated homocysteine levels.
- Elevated homocysteine is a known risk factor for thrombosis.
- Moderate homocysteine increases correlate with venous and arterial thrombotic events.
Purpose of the Study:
- To review the association between homocysteine levels and thrombotic risk.
- To discuss the potential of vitamin therapy to mitigate these risks.
Main Methods:
- Literature review of studies on homocystinuria and thrombosis.
- Analysis of the effects of folic acid, vitamin B12, and vitamin B6 on homocysteine levels.
Main Results:
- Patients with homocystinuria have a significantly increased risk of venous and arterial thrombosis.
- Moderate elevations in homocysteine are associated with deep vein thrombosis, myocardial infarction, cerebral infarction, and peripheral vascular disease.
- Vitamin therapy (folic acid, B12, B6) can effectively reduce homocysteine levels.
Conclusions:
- Elevated homocysteine is a critical risk factor for vascular events in homocystinuria.
- While vitamin supplementation normalizes homocysteine levels, its effect on altering the disease's natural progression remains unproven.
Abstract:
It has been known for some time that patients with homocystinuria are at an increased risk for both venous and arterial thrombosis. More recently it has been found that even moderate increases in homocysteine levels are associated with increased risk for deep venous thrombosis, myocardial infarction, cerebral infarction and peripheral vascular disease. It is possible, with the use of folic acid, vitamin B12 and vitamin B6, to correct the elevated homocysteine levels but it has not yet been demonstrated that by doing so the natural history of the disorder is altered.