Related Experiment Videos
Hyperhomocysteinemia: could the post-methionine oral loading test sometimes be avoided?
Francesco Marongiu1, Lara Fenu, Giulia Pisu
1Dipartimento di Scienze Mediche Internistiche, University of Cagliari, Italy. marongiu@pacs.unica.it
Haematologica
|February 27, 2003
Summary
Fasting total homocysteine (tHcy) levels can predict post-methionine load results, potentially avoiding the need for the oral methionine load test. This could spare nearly 50% of patients this burdensome procedure.
Area of Science:
- Cardiovascular Research
- Clinical Diagnostics
- Biochemistry
Background:
- Homocysteinemia is a risk factor for thrombosis.
- Current measurement involves a 12-hour fast and an oral methionine load (PML).
- The PML procedure is time-consuming and causes patient discomfort.
Purpose of the Study:
- To determine if fasting total homocysteine (tHcy) levels can predict PML and deltaPML tHcy.
- To assess if methionine loading can be avoided by using fasting tHcy levels.
Main Methods:
- Evaluated 381 patients with venous and arterial thrombosis.
- Used receiver operating characteristic curves to assess fasting tHcy for predicting PML and deltaPML tHcy.
- Determined cut-off values for sensitivity and specificity.
Main Results:
- Fasting tHcy correlated with PML and deltaPML tHcy.
- Specific fasting tHcy cut-offs were identified for predicting normal or elevated PML/deltaPML tHcy in males and females.
- 186 patients (PML) and 123 patients (deltaPML) could have avoided methionine loading based on fasting tHcy levels.
Conclusions:
- Fasting tHcy levels can effectively predict the need for methionine loading.
- Approximately 50% of patients could avoid the methionine load test using PML tHcy predictions.
- Around 30% could avoid the test using deltaPML tHcy predictions, simplifying thrombosis risk assessment.