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Updated: Sep 25, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Terminal ileum resection is associated with higher plasma homocysteine levels in Crohn's disease
S Vasilopoulos1, K Saiean, J Emmons
1Division of Gastroenterology and Hepatology, Department of Medicine, Froedtert Memorial Lutheran Hospital, Digestive Disease Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Insights
Elevated total homocysteine (tHcy) is linked to thrombosis risk in Crohn's disease (CD). Terminal ileum resection in CD patients significantly increases tHcy, suggesting screening and vitamin supplementation are recommended.
Area of Science:
- Gastroenterology
- Clinical Biochemistry
- Internal Medicine
Background:
- Elevated plasma total homocysteine (tHcy) is a known risk factor for thrombosis.
- Crohn's disease (CD) is associated with hypercoagulability, but the underlying causes are not fully understood.
- Investigating tHcy in CD patients may elucidate links between disease characteristics and thrombotic risk.
Purpose of the Study:
- To investigate plasma total homocysteine (tHcy) levels in patients with Crohn's disease (CD).
- To explore the relationship between tHcy and vitamin status (folate, vitamin B12), disease activity, location, duration, and history of terminal ileum (TI) resection.
- To identify predictors of elevated tHcy in CD patients.
Main Methods:
- Fasting plasma tHcy, folate, and serum vitamin B12 levels were measured in 125 consecutive adult CD patients.
- Sedimentation rate and Harvey-Bradshaw index were used to assess disease activity.
- Data on history of TI resection and thromboembolism were collected.
Main Results:
- Median plasma tHcy was 10.2 micromol/L in CD patients.
- Men exhibited higher plasma tHcy than women (11.2 vs. 9.1 micromol/L).
- Patients with a history of TI resection had lower serum B12 (293 vs. 503 pg/mL) and higher tHcy (11.0 vs. 9.35 micromol/L) compared to those without resection.
- Multivariate analysis identified TI resection history, serum B12, and creatinine as significant predictors of elevated tHcy.
- CD patients with a history of thrombosis had elevated median tHcy (11.6 micromol/L).
Conclusions:
- Terminal ileum resection is a contributing factor to elevated plasma tHcy in Crohn's disease.
- Screening for tHcy is recommended for CD patients, particularly those with a history of TI resection.
- Vitamin supplementation should be considered for CD patients with elevated tHcy or vitamin deficiencies.
Background:
Elevated plasma total homocysteine (tHcy) is associated with a higher risk of thrombosis. Crohn's disease (CD) is associated with hypercoagulability of undefined etiology. We investigated tHcy in patients with CD and its relationship with vitamin status, disease activity, location, duration, and history of terminal ileum (TI) resection.
Study:
We examined fasting plasma tHcy, folate, serum vitamin B12 levels, and sedimentation rate in consecutive adult patients with CD. Harvey-Bradshaw index of CD activity and history of TI resection and thromboembolism were recorded.
Results:
Median plasma tHcy was 10.2 micromol/L in 125 patients with CD. Men (n = 60) had higher plasma tHcy than women (n = 65) (11.2 vs. 9.1 micromol/L; p = 0.004). Patients with a history of TI resection showed lower serum B12 levels (293 vs. 503 pg/mL; p < 0.001) and higher plasma tHcy levels (11.0 vs. 9.35 micromol/L; p = 0.027) than patients without such history. Multivariate analysis showed history of TI resection, serum B12, and creatinine levels to be significant predictors of elevated plasma tHcy. Fourteen patients with CD with a history of thrombosis had an elevated median plasma tHcy of 11.6 micromol/L.
Conclusions:
Terminal ileum resection contributes to elevated plasma tHcy levels in CD cases. We recommend tHcy screening in patients with CD, especially in those with prior history of TI resection, and the initiation of vitamin supplementation when appropriate.
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