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Plasma homocysteine in venous thromboembolism
L Brattström1, L Tengborn, C Lagerstedt
1Department of Neurology, University of Lund, University Hospital, Sweden.
Insights
This study found no significant difference in plasma homocysteine levels between patients with venous thromboembolism and healthy individuals. However, some male patients showed abnormal responses to methionine loading, suggesting potential heterozygosity for cystathionine synthase deficiency.
Area of Science:
- Biochemistry
- Genetics
- Vascular Medicine
Background:
- Severe hyperhomocysteinemia is linked to arteriosclerosis and thromboembolism.
- Mild hyperhomocysteinemia is associated with arterial occlusive disease.
- The role of homocysteine in venous thromboembolism is less understood.
Purpose of the Study:
- To investigate plasma homocysteine concentrations in patients with venous thromboembolism.
- To compare homocysteine levels in patients and healthy controls.
- To explore potential links between homocysteine metabolism and venous thromboembolism.
Main Methods:
- Measured fasting plasma homocysteine levels.
- Assessed plasma homocysteine after methionine loading.
- Compared levels between 42 venous thromboembolism patients and 42 healthy controls under 50 years of age.
Main Results:
- No significant differences in fasting or post-methionine loading homocysteine levels were observed between patients and controls.
- Male patients showed a trend toward higher homocysteine concentrations compared to male controls.
- Six patients (14%) exhibited abnormal methionine loading responses, suggesting possible cystathionine synthase deficiency heterozygosity.
Conclusions:
- Plasma homocysteine levels do not appear to be a significant differentiating factor in venous thromboembolism in this cohort.
- Abnormal homocysteine metabolism may play a role in a subset of patients with venous thromboembolism.
- Further research is warranted to elucidate the relationship between plasma homocysteine and venous thromboembolism.
Abstract:
Severe hyperhomocysteinemia due to inborn errors of methionine metabolism results in precocious development of arteriosclerosis and predisposition to venous and arterial thromboembolism. Although the findings of several studies have indicated that mild hyperhomocysteinemia is common in occlusive arterial disease, no similar studies have been made on venous thromboembolism. In this study of subjects under 50 years of age, we found no significant differences in the plasma homocysteine concentrations, either in the fasting state or after methionine loading, between 42 patients with venous thromboembolism and 42 healthy controls. Nonetheless, male patients manifested a tendency toward higher homocysteine concentrations than male controls; 6 patients (14%) versus 2 controls (5%) responded abnormally to methionine loading which might indicate heterozygosity for cystathionine synthase deficiency. Thus, further studies on plasma homocysteine in venous thromboembolism are warranted.