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Plasma S-adenosylhomocysteine: A potential risk marker for cerebral venous thrombosis
Venkata Pinnelli Bharatkumar1, Kondapura Jayadevappa Rudreshkumar1, Dindagur Nagaraja2
1Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India.
Insights
Elevated S-adenosylhomocysteine (SAH) is a stronger predictor of cerebral venous thrombosis (CVT) risk than total homocysteine (tHcy). SAH shows higher sensitivity and specificity in identifying individuals at risk for CVT.
Area of Science:
- Neuroscience
- Cardiovascular Science
- Biochemistry
Background:
- Hyperhomocysteinemia is linked to thrombosis risk.
- Limited data exists on S-adenosylhomocysteine (SAH) as a predictor for cerebral venous thrombosis (CVT).
Purpose of the Study:
- To investigate the role of SAH as a risk predictor for CVT.
- To compare the predictive value of SAH and total homocysteine (tHcy) for CVT.
Main Methods:
- Measured plasma concentrations of tHcy, SAH, and S-adenosylmethionine (SAM) in 185 CVT patients and 248 controls.
- Utilized reverse-phase high-performance liquid chromatography with electrochemical detection.
- Performed receiver operating characteristic (ROC) curve analysis and discriminant analysis.
Main Results:
- Plasma tHcy, SAH, and SAM were significantly higher in CVT patients.
- Increased SAH concentrations showed a 35.77-fold increased risk for CVT, compared to 4.54-fold for tHcy.
- SAH demonstrated higher sensitivity and specificity than tHcy in ROC analysis for CVT prediction.
Conclusions:
- Elevated plasma SAH is a more sensitive risk marker for CVT than plasma tHcy.
- SAH may serve as a valuable biomarker for assessing CVT risk.
Background:
Despite a plethora of studies suggesting that hyperhomocysteinemia is associated with an increased risk for arterial and venous thrombosis, there is paucity of data on the role of the S-adenosylhomocysteine (SAH), the metabolic precursor of homocysteine (Hcy) as a risk predictor for cerebral venous thrombosis (CVT).
Method:
We estimated fasting plasma concentrations of total homocysteine (tHcy), SAH and S-adenosylmethionine (SAM), in 185 CVT patients and 248 healthy controls, by reverse-phase high performance liquid chromatography coupled with coulometric electrochemical detection.
Results:
Fasting tHcy, SAH and SAM were significantly higher in patients compared with controls. Increased tHcy and SAH concentrations were associated with 4.54-fold (95% CI, 2.74-7.53) and 35.77-fold (95% CI, 19.45-65.79) increase in risk for CVT, respectively. Receiver operating characteristic (ROC) curve analysis showed that the area under curve, sensitivity and specificity was higher for SAH compared to tHcy. Further, discriminant analysis to distinguish between tHcy and SAH showed that SAH had a significantly higher percentage classification, with lower Wilk's lambda and higher χ(2), compared to tHcy.
Conclusion:
Increased plasma SAH may be a more sensitive risk marker for CVT than plasma tHcy.
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