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[The mechanisms of hyperhomocysteinemia in coronary heart disease]
Insights
Hyperhomocysteinemia (HHe) is identified as an independent risk factor for coronary heart disease (CHD). Elevated homocysteine levels are linked to increased risk, independent of traditional lipid profiles.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Genetics
Context:
- Coronary heart disease (CHD) is a leading cause of mortality worldwide.
- Traditional risk factors include dyslipidemia, hypertension, and smoking.
- The role of homocysteine metabolism in CHD pathogenesis requires further elucidation.
Purpose:
- To investigate hyperhomocysteinemia (HHe) as a novel and independent risk factor for CHD.
- To examine the association between plasma homocysteine (HCY) levels and CHD.
- To assess the influence of MTHFR gene mutations and B vitamin status on HCY levels in CHD patients.
Summary:
- Patients with angiographically confirmed CHD exhibited significantly higher plasma HCY concentrations compared to controls.
- Elevated HCY levels were observed in patients with myocardial infarction, hypertension, and a family history of CHD.
- Plasma HCY showed an inverse correlation with folate and vitamin B12 levels and was higher in individuals with MTHFR 677C-->T mutations.
Impact:
- Establishes hyperhomocysteinemia as an independent risk factor for coronary heart disease.
- Suggests potential therapeutic targets for CHD prevention by managing HCY levels.
- Highlights the interplay between genetic factors, B vitamin status, and cardiovascular risk.
Objective:
To identify hyperhomocysteinemia (HHe) as a new and independent risk factor for coronary heart disease (CHD).
Methods:
The association of coronary heart disease (CHD) and lipid, homocysteine (HCY) and the factors related to its metabolisms were examined. The mutation of the 677C-->T transition of MTHFR was determined by PCR-based assay. Whole blood and plasma folate (FA) and plasma vitamin B12(B12), as cofactors of those enzymes, were determined by radioimmunologic assay. Plasma HCY was determined by HPLC.
Results:
Patients with CHD confirmed by coronary angiography had increased plasma HCY concentrations (17.1 +/- 3.6 mumol/L, 7.6 +/- 1.2 mumol/L). In patients with MI, HPT and family history (FH) of CHD, plasma HCY increased significantly. Plasma HCY concentrations had significant non-linear inverse relation with plasma FA and B12 concentrations. Homozygous mutants showed higher plasma HCY concentrations. Patients with CHD had increased serum CHOL and VLDL levels, but plasma HCY concentrations were not correlated with serum lipid levels.
Conclusion:
Hyperhomocysteinemia is an independent risk factor for coronary heart disease.