Related Experiment Videos
Homocysteine in cerebrovascular disease: an independent risk factor for subcortical vascular encephalopathy
1Department of Clinical Chemistry, Clinic Mannheim, University of Heidelberg, Germany. thomas.bertsch@ikc.ma.uni-heidelberg.de
Insights
High homocysteine levels, a condition known as hyperhomocysteinemia, are a significant risk factor for subcortical vascular encephalopathy (SVE), a cause of dementia. This study confirms hyperhomocysteinemia as an independent risk factor for SVE.
Area of Science:
- Neurology
- Vascular Biology
- Nutritional Science
Background:
- Hyperhomocysteinemia is a known risk factor for large-vessel cerebrovascular disease.
- Subcortical vascular encephalopathy (SVE) is a type of dementia linked to small-vessel cerebral disease.
Purpose of the Study:
- To investigate plasma homocysteine and vitamin levels in SVE patients.
- To compare these levels with patients suffering from large-vessel cerebral disease and healthy controls.
- To determine the association between hyperhomocysteinemia and SVE risk.
Main Methods:
- Plasma concentrations of homocysteine, B vitamins (B6, B12, folate), and other vascular risk factors were measured.
- The study included 82 SVE patients, 144 large-vessel disease patients, and 102 controls.
- Logistic regression analysis was employed to assess risk factors.
Main Results:
- SVE patients exhibited significantly higher homocysteine levels compared to controls.
- Patients with SVE showed lower vitamin B6 levels than controls.
- Elevated homocysteine was the strongest independent risk factor for SVE (OR 5.7).
Conclusions:
- Hyperhomocysteinemia is a potent, independent risk factor for subcortical vascular encephalopathy.
- This finding highlights the importance of homocysteine levels in the context of small-vessel dementia.
- Further research into managing homocysteine may be beneficial for SVE prevention or treatment.
Abstract:
Hyperhomocysteinemia is a risk factor for obstructive large-vessel disease. Here, we studied plasma concentrations of homocysteine and vitamins in patients suffering from subcortical vascular encephalopathy (SVE), a cerebral small-vessel disease leading to dementia. These results were compared to the homocysteine and vitamin plasma concentrations from patients with cerebral large vessel disease and healthy control subjects. Plasma concentrations of homocysteine, vascular risk factors and vitamin status (B6, B12, folate) were determined in 82 patients with subcortical vascular encephalopathy, in 144 patients with cerebral large-vessel disease and in 102 control subjects. Patients with SVE, but not those with cerebral large-vessel disease, exhibited pathologically increased homocysteine concentrations in comparison with control subjects without cerebrovascular disease. Patients with SVE also showed lower vitamin B6 values in comparison to subjects without cerebrovascular disease. Logistic regression analysis showed that homocysteine is associated with the highest risk for SVE (odds ratio 5.7; CI 2.5-12.9) in comparison to other vascular risk factors such as hypertension, age and smoking. These observations indicate that hyperhomocysteinemia is a strong independent risk factor for SVE.