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Significance of hyperhomocysteinemia

Wolfgang Herrmann1

  • 1Clinical Chemistry and Laboratory Medicine/Central Laboratory, Saarland University Clinical Centre, 66421 Homburg, Germany. kchwher@uniklinikum-saarland.de

Clinical Laboratory
|September 8, 2006
PubMed

Insights

High homocysteine (HHCY) is linked to serious health issues. B-vitamin supplementation effectively reduces stroke risk and may lower fracture risk, benefiting cardiovascular and cognitive health.

Area of Science:

  • Biochemistry
  • Public Health
  • Geriatrics

Background:

  • Moderate hyperhomocysteinemia (HHCY) is a significant risk factor for cardiovascular diseases (CVD), neurodegenerative disorders, osteoporotic fractures, and pregnancy complications.
  • Elderly individuals exhibit a high prevalence of HHCY, primarily caused by vitamin deficiencies.

Purpose of the Study:

  • To evaluate the effectiveness of B-vitamin supplementation in mitigating risks associated with HHCY.
  • To highlight the importance of homocysteine level determination in individual risk assessment, particularly for the elderly.

Main Methods:

  • Analysis of retrospective and prospective studies examining the link between HHCY and disease risk.
  • Re-analysis of existing vitamin intervention trials, including the VISP and HOPE 2 studies.
  • Examination of population-level data on folic acid fortification and stroke mortality.

Main Results:

  • B-vitamin supplementation demonstrates convincing effectiveness in lowering stroke risk by approximately 20%.
  • Folic acid fortification in North America has led to a substantial decrease in stroke mortality.
  • Vitamin treatment significantly reduced fracture risk in individuals with HHCY.
  • HHCY is correlated with cognitive decline, Alzheimer's disease, and chronic heart failure.

Conclusions:

  • Despite mixed results in some CVD prevention trials, B-vitamin supplementation is effective for stroke risk reduction.
  • Homocysteine plasma concentration determination is crucial for identifying individuals at risk for CVD, neurodegenerative diseases, and osteoporotic fractures.
  • Vitamin B12 supplementation, alongside folate, may offer additional benefits in preventing pregnancy complications.

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