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Hyperhomocysteinemia in Greek patients with inflammatory bowel disease
I E Koutroubakis1, E Dilaveraki, I G Vlachonikolis
1Department of Gastroenterology, University Hospital Heraklion, Crete, Greece.
Insights
Mild hyperhomocysteinemia is common in Greek patients with inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn
Area of Science:
- Vascular Medicine
- Gastroenterology
- Clinical Biochemistry
Background:
- Inflammatory bowel disease (IBD) is associated with an increased risk of thromboembolic events.
- Hyperhomocysteinemia is a recognized risk factor for both arterial and venous thrombosis.
- The prevalence and clinical significance of hyperhomocysteinemia in IBD patients, particularly in Greece, require further investigation.
Purpose of the Study:
- To investigate the prevalence of hyperhomocysteinemia in Greek patients with ulcerative colitis (UC) and Crohn's disease (CD).
- To assess the clinical significance of elevated homocysteine levels in IBD patients concerning thrombotic risk.
- To compare homocysteine and folate levels between IBD patients and healthy controls.
Main Methods:
- A study involving 108 consecutive IBD patients (53 UC, 55 CD) and 74 healthy controls (HC).
- Data collection included interviews for thrombotic risk factors and measurement of serum total homocysteine (tHcy), folate, cobalamin, and lipid profiles.
- Statistical analysis, including covariance analysis, was used to adjust for confounding variables.
Main Results:
- IBD patients exhibited significantly higher serum total homocysteine (tHcy) levels compared to healthy controls (UC: 15.9 ± 10.3; CD: 13.6 ± 6.5; HC: 9.6 ± 3.4 μmol/L).
- Both UC and CD patients had lower serum folate levels than healthy controls.
- Elevated homocysteine levels in IBD patients remained significant after adjusting for age, gender, and other clinical variables.
Conclusions:
- Mild hyperhomocysteinemia is prevalent in Greek IBD patients.
- This condition may contribute to the heightened thrombotic risk observed in patients with inflammatory bowel disease.
- Further research is warranted to explore therapeutic strategies for managing hyperhomocysteinemia in IBD.
Abstract:
In recent years hyperhomocysteinemia has been established as a new risk factor for arterial and venous thrombosis. Since patients with inflammatory bowel disease (IBD) frequently suffer from thromboembolic events, we studied the prevalence and clinical significance of hyperhomocysteinemia in Greek patients with ulcerative colitis (UC) and Crohn's disease (CD). In 108 consecutive fasting IBD patients (53 UC and 55 CD) and 74 healthy controls (HC), a standard record of various clinical thrombotic risk factors was completed by interview, and fasting serum concentrations of total homocysteine (tHcy), folate, cobalamin, creatinine, cholesterol, HDL, LDL, and triglycerides were measured. The concentration (mean +/- SD) of serum tHcy was significantly higher in UC (15.9 +/- 10.3 micromol/liter) and CD patients (13.6 +/- 6.5) than in controls (9.6 +/- 3.4, P < 0.05). Both UC and CD patients had lower levels of folate than HC (P < 0.05). Covariance analysis of age, gender, and all clinical variables indicated that the differences in homocysteine levels between IBD patients and HC remain significant even after adjustment for these covariates. In conclusion, mild hyperhomocysteinemia is common in Greek IBD patients and may account for the increased thrombotic risk of these patients.